A nomogram to predict non-sentinel lymph node metastasis for breast cancer patients with positive axillary sentinel lymph node
10.3760/cma.j.cn112152-20190824-00545
- VernacularTitle:腋窝前哨淋巴结阳性乳腺癌患者腋窝非前哨淋巴结转移风险预测
- Author:
Zhuanbo YANG
1
;
Zhou HUANG
;
Shulian WANG
;
Yu TANG
;
Hao JING
;
Jianyang WANG
;
Jianghu ZHANG
;
Yong YANG
;
Yongwen SONG
;
Hui FANG
;
Jing JIN
;
Yueping LIU
;
Shunan QI
;
Ning LI
;
Yuan TANG
;
Ningning LU
;
Bo CHEN
;
Xiang WANG
;
Jidong GAO
;
Jing WANG
;
Lixue XUAN
;
Yi FANG
;
Yexiong LI
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院放疗科 100021
- Keywords:
Breast neoplasms;
Sentinel lymph node;
Non-sentinel lymph node;
Lymph node metastasis;
Nomogram;
Prediction Model
- From:
Chinese Journal of Oncology
2020;42(8):653-659
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1~2 positive axillary sentinel lymph node (SLN) and construct an accurate prediction model.Methods:Retrospective chart review was performed in 917 breast cancer patients who underwent surgery treatment between 2002 and 2017 and pathologically confirmed 1-2 positive SLNs. According to the date of surgery, patients were divided into training group (497 cases) and validation group (420 cases). A nomogram was built to predict nSLN metastasis and the accuracy of the model was validated.Results:Among the 917 patients, 251 (27.4%) had nSLN metastasis. Univariate analysis showed tumor grade, lymphovascular invasion (LVI), extra-capsular extension (ECE), the number of positive and negative SLN and macro-metastasis of SLN were associated with nSLN metastasis (all P<0.05). Multivariate Logistic regression analysis showed the numbers of positive SLN, negative SLN and macro-metastasis of SLN were independent predictors of nSLN metastasis (all P<0.05). A nomogram was constructed based on the 6 factors. The area under the receiver operating characteristic curve was 0.718 for the training group and 0.742 for the validation group. Conclusion:We have developed a nomogram that uses 6 risk factors commonly available to accurately estimate the likelihood of nSLN metastasis for individual patient, which might be helpful for radiation oncologists to make a decision on regional nodal irradiation.
