A Novel Prognostic Nomogram for Predicting Risks of Distant Failure in Patients with Invasive Breast Cancer Following Postoperative Adjuvant Radiotherapy.
- Author:
Yu Jin LIM
1
;
Sea Won LEE
;
Noorie CHOI
;
Jeanny KWON
;
Keun Yong EOM
;
Eunyoung KANG
;
Eun Kyu KIM
;
Jee Hyun KIM
;
Yu Jung KIM
;
Se Hyun KIM
;
So Yeon PARK
;
In Ah KIM
Author Information
- Publication Type:Original Article
- Keywords: Breast neoplasms; Adjuvant radiotherapy; Nomogram; Neoplasm metastasis; Prognosis
- MeSH: Brain; Breast Neoplasms*; Breast*; Follow-Up Studies; Humans; Mortality; Multivariate Analysis; Neoplasm Metastasis; Nomograms*; Phenobarbital; Prognosis; Proportional Hazards Models; Radiotherapy, Adjuvant*; Recurrence
- From:Cancer Research and Treatment 2018;50(4):1140-1148
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This study aimed to identify predictors for distant metastatic behavior and build a related prognostic nomogram in breast cancer. MATERIALS AND METHODS: A total of 1,181 patients with non-metastatic breast cancer between 2003 and 2011 were analyzed. To predict the probability of distant metastasis, a nomogram was constructed based on prognostic factors identified using a Cox proportional hazards model. RESULTS: The 7-year overall survival and 5-year post-progression survival of locoregional versus distant recurrence groups were 67.6% versus 39.1% (p=0.027) and 54.2% versus 33.5% (p=0.043), respectively. Patients who developed distant metastasis showed early and late mortality risk peaks within 3 and after 5 years of follow-up, respectively, but a broad and low risk increment was observed in other patients with locoregional relapse. In multivariate analysis of distant metastasis-free interval, age (≥ 45 years vs. < 45 years), molecular subtypes (luminal A vs. luminal B, human epidermal growth receptor 2, and triple negative), T category (T1 vs. T2-3 and T4), and N category (N0 vs. N1 and N2-3) were independently associated (p < 0.05 for all). Regarding the significant factors, a well-validated nomogram was established (concordance index, 0.812). The risk score level of patients with initial brain failure was higher than those of non-brain sites (p=0.029). CONCLUSION: The nomogram could be useful for predicting the individual probability of distant recurrence in breast cancer. In high-risk patients based on the risk scores, more aggressive systemic therapy and closer surveillance for metastatic failure should be considered.
