- Volume 13 Issue 12
DOI QR Code
Validation of Three Breast Cancer Nomograms and a New Formula for Predicting Non-sentinel Lymph Node Status
- Derici, Serhan (Akcaabat State Hospital) ;
- Sevinc, Ali (Dokuz Eylul University Hospital) ;
- Harmancioglu, Omer (Dokuz Eylul University Hospital) ;
- Saydam, Serdar (Dokuz Eylul University Hospital) ;
- Kocdor, Mehmet (Dokuz Eylul University Hospital) ;
- Aksoy, Suleyman (Tepecik Training and Research Hospital) ;
- Egeli, Tufan (Dokuz Eylul University Hospital) ;
- Canda, Tulay (Dokuz Eylul University Hospital) ;
- Ellidokuz, Hulya (Dokuz Eylul University Hospital) ;
- Derici, Solen (Akcaabat State Hospital)
- Published : 2012.12.31
Background: The aim of the study was to evaluate the available breast nomograms (MSKCC, Stanford, Tenon) to predict non-sentinel lymph node metastasis (NSLNM) and to determine variables for NSLNM in SLN positive breast cancer patients in our population. Materials and Methods: We retrospectively reviewed 170 patients who underwent completion axillary lymph node dissection between Jul 2008 and Aug 2010 in our hospital. We validated three nomograms (MSKCC, Stanford, Tenon). The likelihood of having positive NSLNM based on various factors was evaluated by use of univariate analysis. Stepwise multivariate analysis was applied to estimate a predictive model for NSLNM. Four factors were found to contribute significantly to the logistic regression model, allowing design of a new formula to predict non-sentinel lymph node metastasis. The AUCs of the ROCs were used to describe the performance of the diagnostic value of MSKCC, Stanford, Tenon nomograms and our new nomogram. Results: After stepwise multiple logistic regression analysis, multifocality, proportion of positive SLN to total SLN, LVI, SLN extracapsular extention were found to be statistically significant. AUC results were MSKCC: 0.713/Tenon: 0.671/Stanford: 0.534/DEU: 0.814. Conclusions: The MSKCC nomogram proved to be a good discriminator of NSLN metastasis in SLN positive BC patients for our population. Stanford and Tenon nomograms were not as predictive of NSLN metastasis. Our newly created formula was the best prediction tool for discriminate of NSLN metastasis in SLN positive BC patients for our population. We recommend that nomograms be validated before use in specific populations, and more than one validated nomogram may be used together while consulting patients.
Breast cancer;sentinel lymph node;nomogram;axillary dissection;non sentinel lymph node metastasis
- Unal B, Gur AS (2008). Models for predicting non-sentinel lymph node positivity in sentinel node positive breast cancer: the importance of scoring system. Int J Clinical Practice, 62, 1785-91. https://doi.org/10.1111/j.1742-1241.2008.01887.x
- Van Zee KJ, Manasseh DM (2003). A nomogram for predicting the likelihood of additional nodal metastasis in breast cancer patients with a positive sentinel node biopsy. Annals of Surgical Oncology, 10, 1140-51 https://doi.org/10.1245/ASO.2003.03.015
- Barranger E, Coutant C (2005). An axilla scoring system to predict non-sentinel lymph node status in breast cancer patients with sentinel lymph node involvement. Breast Cancer Res and Treatment, 91, 113-9. https://doi.org/10.1007/s10549-004-5781-z
- Chen JJ, Wu J (2010). Management strategy of early-stage breast cancer patients with a positive sentinel lymph node with or without axillary lymph node dissection. Crit Rev Oncol Hematol, 79, 293-301.
- Gur AS, Unal B (2010). Validation of breast cancer nomograms for predicting the non-sentinel lymph node metastases after a positive sentinel lymph node biopsy in a multi-center study. Eur J Surg Oncology, 36, 30-5. https://doi.org/10.1016/j.ejso.2009.05.007
- Holbrook EK, Olshen RA (2008). New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients. BMC Cancer, 8, 66. https://doi.org/10.1186/1471-2407-8-66
- Jemal A, Siegel R, Xu J, Ward E (2010). Cancer statistics. Ca Cancer J Clin, 2010, 60.
- Latosinsky S, Dabbs K (2008). Canadian association of general surgeons and american college of surgeons evidence-based reviews in surgery. quality-of-life outcomes with sentinel node biopsy versus standard axillary treatment in patients with operable breast cancer. Canadian J Surg, 51, 483-5.
- Pal A, Provenzano E (2008). A model for predicting non-sentinel lymph node metastatic disease when the sentinel lymph node is positive. Bri J Surg, 95, 302-9. https://doi.org/10.1002/bjs.5943
- Prognostic Evaluation of Categorical Platelet-based Indices Using Clustering Methods Based on the Monte Carlo Comparison for Hepatocellular Carcinoma vol.15, pp.14, 2014, https://doi.org/10.7314/APJCP.2014.15.14.5721
- Clinicopathologic Features Predicting Involvement of Nonsentinel Axillary Lymph Nodes in Iranian Women with Breast Cancer vol.15, pp.17, 2014, https://doi.org/10.7314/APJCP.2014.15.17.7049
- A Breast Cancer Nomogram for Prediction of Non-Sentinel Node Metastasis - Validation of Fourteen Existing Models vol.15, pp.3, 2014, https://doi.org/10.7314/APJCP.2014.15.3.1481