A mathematical prediction model incorporating molecular subtype for risk of non-sentinel lymph node metastasis in sentinel lymph node-positive breast cancer patients: a retrospective analysis and nomogram development
| Autor: | Xue Wang, Zheng-jun Yang, Hongmeng Zhao, Li-xuan Chen, Na-na Wang, Wen-feng Cao, Bin Zhang |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Risk 0301 basic medicine Oncology medicine.medical_specialty Sentinel lymph node Breast Neoplasms Metastasis 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine medicine Humans Pharmacology (medical) Radiology Nuclear Medicine and imaging Prospective cohort study Lymph node Aged Retrospective Studies Aged 80 and over business.industry Axillary Lymph Node Dissection General Medicine Middle Aged Models Theoretical Nomogram medicine.disease Nomograms 030104 developmental biology medicine.anatomical_structure Lymphatic Metastasis 030220 oncology & carcinogenesis Female Lymph Sentinel Lymph Node business |
| Zdroj: | Breast Cancer. 25:629-638 |
| ISSN: | 1880-4233 1340-6868 |
| Popis: | Molecular subtype of breast cancer is associated with sentinel lymph node status. We sought to establish a mathematical prediction model that included breast cancer molecular subtype for risk of positive non-sentinel lymph nodes in breast cancer patients with sentinel lymph node metastasis and further validate the model in a separate validation cohort. We reviewed the clinicopathologic data of breast cancer patients with sentinel lymph node metastasis who underwent axillary lymph node dissection between June 16, 2014 and November 16, 2017 at our hospital. Sentinel lymph node biopsy was performed and patients with pathologically proven sentinel lymph node metastasis underwent axillary lymph node dissection. Independent risks for non-sentinel lymph node metastasis were assessed in a training cohort by multivariate analysis and incorporated into a mathematical prediction model. The model was further validated in a separate validation cohort, and a nomogram was developed and evaluated for diagnostic performance in predicting the risk of non-sentinel lymph node metastasis. Moreover, we assessed the performance of five different models in predicting non-sentinel lymph node metastasis in training cohort. Totally, 495 cases were eligible for the study, including 291 patients in the training cohort and 204 in the validation cohort. Non-sentinel lymph node metastasis was observed in 33.3% (97/291) patients in the training cohort. The AUC of MSKCC, Tenon, MDA, Ljubljana, and Louisville models in training cohort were 0.7613, 0.7142, 0.7076, 0.7483, and 0.671, respectively. Multivariate regression analysis indicated that tumor size (OR = 1.439; 95% CI 1.025–2.021; P = 0.036), sentinel lymph node macro-metastasis versus micro-metastasis (OR = 5.063; 95% CI 1.111–23.074; P = 0.036), the number of positive sentinel lymph nodes (OR = 2.583, 95% CI 1.714–3.892; P |
| Databáze: | OpenAIRE |
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