Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter Study
PurposeThe aim of this study was to develop a widely accepted prognostic nomogram and establish a risk-adapted PMRT strategy based on locoregional recurrence for pT1-2N1M0 breast cancer.Methods and MaterialsA total of 3,033 patients with pT1-2N1M0 breast cancer treated at 6 participating institution...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.588859/full |
| _version_ | 1818352267383799808 |
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| author | Ming Li Jinbo Yue Xiangbo Wan Bin Hua Qiuan Yang Pei Yang Zijian Zhang Qian Pei Weidong Han Yaping Xu Xuefeng Xia |
| author_facet | Ming Li Jinbo Yue Xiangbo Wan Bin Hua Qiuan Yang Pei Yang Zijian Zhang Qian Pei Weidong Han Yaping Xu Xuefeng Xia |
| author_sort | Ming Li |
| collection | DOAJ |
| description | PurposeThe aim of this study was to develop a widely accepted prognostic nomogram and establish a risk-adapted PMRT strategy based on locoregional recurrence for pT1-2N1M0 breast cancer.Methods and MaterialsA total of 3,033 patients with pT1-2N1M0 breast cancer treated at 6 participating institutions between 2000 and 2016 were retrospectively reviewed. A nomogram was developed to predicted locoregional recurrence-free survival (LRFS). A propensity score-matched (PSM) analyses was performed in risk-adapted model.ResultsWith the median follow-up of 65.0 months, the 5-year overall survival (OS), disease free survival (DFS) and LRFS were 93.0, 84.8, and 93.6%, respectively. There was no significant difference between patients who received PMRT or not for the entire group. A nomogram was developed and validated to estimate the probability of 5-year LRFS based on five independent factors including age, primary tumor site, positive lymph nodes number, pathological T stage, and molecular subtype that were selected by a multivariate analysis of patients who did not receive PMRT in the primary cohort. According to the total nomogram risk scores, the entire patients were classified into low- (40.0%), moderate- (42.4%), and high-risk group (17.6%). The 5-year outcomes were significantly different among these three groups (P<0.001). In low-risk group, patients who received PMRT or not both achieved a favorable OS, DFS, and LRFS. In moderate-risk group, no differences in OS, DFS, and LRFS were observed between PMRT and no PMRT patients. In high-risk group, compared with no PMRT, PMRT resulted in significantly different OS (86.8 vs 83.9%, P = 0.050), DFS (77.2 vs 70.9%, P = 0.049), and LRFS (90.8 vs. 81.6%, P = 0.003). After PSM adjustment, there were no significant differences in OS, DFS, and LRFS in low-risk and moderate-risk groups. However, in the high-risk group, PMRT still resulted in significantly better OS, DFS and improved LRFS.ConclusionsThe proposed nomogram provides an individualized risk estimate of LRFS in patients with pT1-2N1M0 breast cancer. Risk-adapted PMRT for high-risk patients is a viable effective strategy. |
| first_indexed | 2024-12-13T18:50:55Z |
| format | Article |
| id | doaj.art-5ef7fc8d45b84f979de54eb6096a6b7a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-13T18:50:55Z |
| publishDate | 2020-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-5ef7fc8d45b84f979de54eb6096a6b7a2022-12-21T23:34:56ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-12-011010.3389/fonc.2020.588859588859Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter StudyMing Li0Jinbo Yue1Xiangbo Wan2Bin Hua3Qiuan Yang4Pei Yang5Zijian Zhang6Qian Pei7Weidong Han8Yaping Xu9Xuefeng Xia10Department of Radiation Oncology, Beijing Hospital/National Center of Gerontology, Beijing, ChinaDepartment of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University/Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Radiation Oncology, The Sixth Affiliated Hospital - Sun Yat-sen University, Guangzhou, ChinaDepartment of Breast Cancer Surgery, Beijing Hospital/National Center of Gerontology, Beijing, ChinaDepartment of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Radiation Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine - Central South University, Changsha, ChinaDepartment of Radiation Oncology, Xiangya Hospital - Central South University, Changsha, ChinaDepartment of General Surgery, Xiangya Hospital - Central South University, Changsha, ChinaDepartment of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China0Geneplus-Beijing Institute, Beijing, China0Geneplus-Beijing Institute, Beijing, ChinaPurposeThe aim of this study was to develop a widely accepted prognostic nomogram and establish a risk-adapted PMRT strategy based on locoregional recurrence for pT1-2N1M0 breast cancer.Methods and MaterialsA total of 3,033 patients with pT1-2N1M0 breast cancer treated at 6 participating institutions between 2000 and 2016 were retrospectively reviewed. A nomogram was developed to predicted locoregional recurrence-free survival (LRFS). A propensity score-matched (PSM) analyses was performed in risk-adapted model.ResultsWith the median follow-up of 65.0 months, the 5-year overall survival (OS), disease free survival (DFS) and LRFS were 93.0, 84.8, and 93.6%, respectively. There was no significant difference between patients who received PMRT or not for the entire group. A nomogram was developed and validated to estimate the probability of 5-year LRFS based on five independent factors including age, primary tumor site, positive lymph nodes number, pathological T stage, and molecular subtype that were selected by a multivariate analysis of patients who did not receive PMRT in the primary cohort. According to the total nomogram risk scores, the entire patients were classified into low- (40.0%), moderate- (42.4%), and high-risk group (17.6%). The 5-year outcomes were significantly different among these three groups (P<0.001). In low-risk group, patients who received PMRT or not both achieved a favorable OS, DFS, and LRFS. In moderate-risk group, no differences in OS, DFS, and LRFS were observed between PMRT and no PMRT patients. In high-risk group, compared with no PMRT, PMRT resulted in significantly different OS (86.8 vs 83.9%, P = 0.050), DFS (77.2 vs 70.9%, P = 0.049), and LRFS (90.8 vs. 81.6%, P = 0.003). After PSM adjustment, there were no significant differences in OS, DFS, and LRFS in low-risk and moderate-risk groups. However, in the high-risk group, PMRT still resulted in significantly better OS, DFS and improved LRFS.ConclusionsThe proposed nomogram provides an individualized risk estimate of LRFS in patients with pT1-2N1M0 breast cancer. Risk-adapted PMRT for high-risk patients is a viable effective strategy.https://www.frontiersin.org/articles/10.3389/fonc.2020.588859/fullbreast neoplasmsmastectomyradiation therapynomogramrisk-adapted therapymolecular subtype |
| spellingShingle | Ming Li Jinbo Yue Xiangbo Wan Bin Hua Qiuan Yang Pei Yang Zijian Zhang Qian Pei Weidong Han Yaping Xu Xuefeng Xia Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter Study Frontiers in Oncology breast neoplasms mastectomy radiation therapy nomogram risk-adapted therapy molecular subtype |
| title | Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter Study |
| title_full | Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter Study |
| title_fullStr | Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter Study |
| title_full_unstemmed | Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter Study |
| title_short | Risk-Adapted Postmastectomy Radiotherapy Decision Based on Prognostic Nomogram for pT1-2N1M0 Breast Cancer: A Multicenter Study |
| title_sort | risk adapted postmastectomy radiotherapy decision based on prognostic nomogram for pt1 2n1m0 breast cancer a multicenter study |
| topic | breast neoplasms mastectomy radiation therapy nomogram risk-adapted therapy molecular subtype |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2020.588859/full |
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