A simplified breast cancer prognostic score: comparison with the AJCC clinical prognostic staging system

Fei, Fei; Zhang, Kui; Siegal, Gene P.; Wei, Shi

doi:10.1038/s41379-021-00890-y

Cited by 4 publications

(4 citation statements)

References 29 publications

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Section: Discussionmentioning

confidence: 99%

“…52 The other possible reason might be that patients with a higher ENO1 expression level were more likely to be in the early stage of breast cancer, and clinical stage played a greater impact on the prognosis of breast cancer than ER, PR, and HER2. 53,54 There were some limitations in this study. First, only patients with tumors >1 cm were included, which may lead to selective bias.…”

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confidence: 95%

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Association of Enolase-1 with Prognosis and Immune Infiltration in Breast Cancer by Clinical Stage

Shi¹,

Chen²,

Chen³

et al. 2023

JIR

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Purpose Enolase-1 (ENO1) plays a key role in malignancies. Previous studies on the association between ENO1 expression and breast cancer prognosis had yielded inconsistent results. In the present study, we assessed the prognostic effect of ENO1 in breast cancer using Guangzhou Breast Cancer Study (GZBCS) cohort with full consideration of the potential confounders and the modification effects. The results were further validated in the TCGA-BRCA cohort and explained by tumor immunity. Methods ENO1 protein expressions were evaluated by immunohistochemistry in tissue microarrays from 961 patients with primary invasive breast cancer. Chi-square tests were used to assess the association of ENO1 levels with the patient’s characteristics. Cox regression models were applied to assess the prognostic effects. The TCGA-BRCA cohort was utilized to validate the results and explore the potential mechanisms. The immune infiltration was determined using the CIBERSORT and ssGSEA algorithms; the correlation between ENO1 expression and the abundance of tumor-infiltrating immune cells (TIICs) and scores of immune-related functions was evaluated by Wilcoxon signed-rank tests and Spearman’s rank test. Results ENO1 protein expression exerted a protective effect on OS in stage I/II patients (HR=0.58, 95% CI: 0.35–0.96) but not in stage III patients (HR=1.42, 95% CI: 0.81–2.49, P interaction =0.04) in GZBCS; consistent results were obtained at mRNA levels in TCGA cohort. Immune infiltration analyses revealed that ENO1 was positively correlated with multiple antitumor TIICs (including M1 macrophages, B cells, CD8 T cells, T helper 2 cells, and NK cells) only in stage I/II but not stage III patients. Conclusion A higher expression of ENO1 was associated with a better prognosis only in early-stage breast cancer, which may be related to the different effects of ENO1 on immune infiltration, suggesting that ENO1 may be a promising target for precision immunotherapy in breast cancer.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 95%

Association of Enolase-1 with Prognosis and Immune Infiltration in Breast Cancer by Clinical Stage

Shi¹,

Chen²,

Chen³

et al. 2023

JIR

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“…Analyses of prognostic factors on survival are essential for patients and professionals and impact on health policy. Scientific evidence has demonstrated the prognostic value of different variables, such as age, ethnicity, tumor size, histology, histological grade, stage at diagnosis, hormone receptor status, and the surgical and adjuvant treatment patients receive [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Survival of Breast Cancer by Stage, Grade and Molecular Groups in Mallorca, Spain

Pascual

Moreno

Franch

et al. 2022

JCM

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The aims of this study are: (1) to determine cause-specific survival by stage, grade, and molecular groups of breast cancer, (2) to identify factors which explain and predict the likelihood of survival and the risk of dying from this cancer; and (3) to find out the distribution of breast cancer cases by stage, grade, and molecular groups in females diagnosed in the period 2006–2012 in Mallorca (Spain). We collected data regarding age, date and diagnostic method, histology, laterality, sublocation, pathological or clinical tumor size (T), pathological or clinical regional lymph nodes (N), metastasis (M) and stage, histologic grade, estrogen and progesterone receptors status, HER-2 expression, Ki67 level, molecular classification, date of last follow-up or date of death, and cause of death. We identified 2869 cases. Cause-specific survival for the entire sample was 96% 1 year after diagnosis, 91% at 3 years and 87% at 5 years. Relative survival was 96.9% 1 year after diagnosis, 92.6% at 3 years and 88.5% at 5 years. The competing-risks regression model determined that patients over 65 years of age and patients with triple negative cancer have worse prognoses, and as stages progress, the prognosis for breast cancer worsens, especially from stage III.

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“…In the era of neoadjuvant treatment, the 10-lymph node guideline for axillary lymph node dissection in breast cancer may need to be revised. Currently, lymph node status remains an important factor in the AJCC prognostic staging and remains an essential determinant of adjuvant treatment decision-making (38). Lymph node staging is still based on positive lymph node count in breast cancer patients received neoadjuvant chemotherapy, but the varying effects of neoadjuvant chemotherapy on axillary lymph nodes is not considered.…”

Section: Discussionmentioning

confidence: 99%

The prognostic role of lymph node ratio in breast cancer patients received neoadjuvant chemotherapy: A dose-response meta-analysis

Liu

Zhang

et al. 2022

Front. Surg.

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BackgroundAs neoadjuvant chemotherapy is widely used in breast cancer patients, the lymph node ratio has not been fully validated as a prognostic indicator of breast cancer received neoadjuvant chemotherapy. This study was conducted to investigate the prognostic value of lymph node ratio in breast cancer patients received neoadjuvant chemotherapy.MethodsSystematic searches were performed in the PubMed, Embase, and Cochrane Library databases until 15 December 2021 for studies on the association between lymph node ratio and the prognosis of breast cancer after neoadjuvant chemotherapy. Overall survival and disease-free survival were used as outcome events, and hazard ratio was chosen as the parameter to evaluate the correlation. The dose-response relationship was assessed by restricted cubic splines. In the subgroup analyses, which were used to explore potential heterogeneity among the included studies according to study region and sample size. Sensitivity analysis was performed to assess the stability of individual studies, and publication bias was determined with funnel plots, Begg’s test, and Egger&apos;s test. All statistical analyses were performed using Stata 15.1.ResultsA total of 12 studies with 4,864 patients were included in this meta-analysis. In this study, high lymph node ratio was significantly associated with decreased overall survival (HR: 4.74; 95%CI: 3.36–6.67; P < 0.001) and disease-free survival (HR: 4.77; 95%CI: 3.69–6.17; P < 0.001). Moreover, the dose-response meta-analysis showed a linear association between higher lymph node ratio and shorter overall survival and disease-free survival in breast cancer patients after neoadjuvant chemotherapy.ConclusionsThe meta-analysis suggested that high lymph node ratio was significantly associated with short overall survival and disease-free survival in breast cancer patients after neoadjuvant chemotherapy. Therefore, lymph node ratio is an independent predictive factor for the prognosis of breast cancer patients after neoadjuvant chemotherapy, which may better refine the cancer staging system.

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A simplified breast cancer prognostic score: comparison with the AJCC clinical prognostic staging system

Cited by 4 publications

References 29 publications

Association of Enolase-1 with Prognosis and Immune Infiltration in Breast Cancer by Clinical Stage

Association of Enolase-1 with Prognosis and Immune Infiltration in Breast Cancer by Clinical Stage

Survival of Breast Cancer by Stage, Grade and Molecular Groups in Mallorca, Spain

The prognostic role of lymph node ratio in breast cancer patients received neoadjuvant chemotherapy: A dose-response meta-analysis

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