Predicting Non‐sentinel Lymph Node Metastasis in a Chinese Breast Cancer Population with 1–2 Positive Sentinel Nodes: Development and Assessment of a New Predictive Nomogram

Chen, Jia Ying; Chen, Jia Jian; Xue, Jing; Chen, Ying; Liu, Guang Yu; Han, Qi; Wen, Yan; Shen, Zhen; Shao, Zhi Min; Wu, Jiong

doi:10.1007/s00268-015-3189-z

Cited by 21 publications

(27 citation statements)

References 43 publications

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“…There are several studies taking into account the clinicopathologic factors predicting non-SLN metastasis (10)(11)(12). LVI and number of positive and negative SLNs and their sizes are predic- (13).…”

Section: Discussionmentioning

confidence: 99%

Can Neutrophil to Lymphocyte Ratio Be a Predictor Tool for The Non-Sentinel Lymph Node Metastasis in Breast Cancer?

Atak¹,

Serkan²,

Tuba³

et al. 2019

chr

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RezumatScop: Investigarea unei potenţiale relaţiii între raportul neutrofile /limfocite (NLR) şi procentul metastazării nodurilor limfatice nonsantinelă (NSLN) în cancerul mamar timpuriu. Metode: Datele clinice ale pacienţilor cu cancer mamar invaziv în stadiu incipient clinic (cT1-3,N0), care au beneficiat de biopsie ghidată cu substanţă de contrast şi limfoscintigrafic între Aprilie 2015 şi Ianuarie 2017, au fost prelucrate retrospectiv. Valoarea NLR la întregul grup de pacienţi, indiferent de statusul NSLN, a fost înregistrată pre-tratament. Rezultate: Un număr total de 178 de pacienţi cu vârsta medie de 51,65±10,93 ani au fost incluşi în studiu. NLR a fost statistic semnificativ la pacienţii cu NSLN invadat (p=0.011). Invazia limfovasculară şi extensia extracapsulară la nivelul nodului limfatic santinelă (SLN) au intervenit mai frecvent la pacienţii NSLN invadat (p<0.05). Riscul de metastazare în nodurile limfatice (N1) la pacienţii cu invazie limfovasculară a fost semnificativ mai ridicat (OR 3,733 (95% CI: 1,05-13,24). Riscul de metastazare la nivelul NSLN a fost de circa 10 ori mai ridicat la pacienţii cu invazie capsulară comparativ cu cei fără invazie capsulară (OR 10,267; 95% CI: 2,12). Concluzii: İnvazia limfovasculară, extensia extracapsulară şi NLR reprezintă parametrii predictivi ai pozitivităţii NSLN. Calcularea preoperatorie a NLR reprezintă un instrument predictiv util în ceea ce priveşte estimarea riscului de invazie malignă a NSLN.

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Section: Discussionmentioning

confidence: 99%

Can Neutrophil to Lymphocyte Ratio Be a Predictor Tool for The Non-Sentinel Lymph Node Metastasis in Breast Cancer?

Atak¹,

Serkan²,

Tuba³

et al. 2019

chr

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“…Series agree in terms of tumor size, histological grade, lymphovascular invasion, number of SLN resected, macrometastatic nodal disease, and extracapsular extension as predictive factors [6,7,8,9,10,11,12]. Furthermore, some of these analyses have proposed and developed the use of nomograms to estimate the risk of metastatic disease in axillary nodes in order to define if ALND is needed [24,25]. …”

Section: Discussionmentioning

confidence: 99%

Predictive Factors for Non-Sentinel Lymph Node Metastasis in Patients with ACOSOG Z0011 Criteria

et al. 2018

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Background: Nodal staging constitutes an element of great importance in the treatment planning for early breast cancer. The ACOSOG Z0011 trial demonstrated that sentinel lymph node (SLN) biopsy alone results in rates of local control, disease-free survival, and overall survival equivalent to those seen after axillary lymph node dissection. The purpose of this study was to determine the rate of patients that fulfill the ACOSOG Z0011 inclusion criteria and to define predictive factors for non-SLN positivity. Methods: A retrospective analysis of the breast surgery database of the Argentinian Society of Mastology was carried out. Patients were selected if they fulfilled the ACOSOG Z0011 inclusion criteria. The association of clinical and pathological factors with non-SLN positivity was evaluated in univariate and multivariate analysis. Results: Among 8,262 patients, 973 had positive SLN, and 348 satisfied the inclusion criteria. Histological grade (G3 vs. G1-2, odds ratio (OR) 1.81; p = 0.024), tumor size (T2 vs. T1, OR 2.39; p = 0.001), and age (>50 vs. <50 years, OR 1.95; p = 0.007) were associated with non-SLN positivity in multivariate analysis. Conclusion: Although the clinical relevance of our data is not established, older women with tumors bigger than 2 cm and/or high histological grade are at greater risk of having metastatic disease in the lymph nodes if axillary lymph node dissection is avoided. This subgroup of patients represents only 30% of the trial population.

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“…Thus, these values are unclear prior to surgery. Two publications considered the numbers of positive and negative SLNs as the independent risk factors included in their prediction models [26,27]. The SLN metastasis ratio was incorporated into the model predictions in another clinical study [28].…”

Section: Discussionmentioning

confidence: 99%

Development of a prediction model based on LASSO regression to evaluate the risk of non-sentinel lymph node metastasis in Chinese breast cancer patients with 1-2 positive sentinel lymph nodes

Meng

Tian

Wang

et al. 2020

Preprint

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Background: Our study aimed to investigate the correlative factors influencing non-sentinel lymph node (NSLN) metastasis in Chinese breast cancer patients with 1-2 positive sentinel lymph nodes (SLNs) and to develop an intraoperative prediction model based on the least absolute shrinkage and selection operator (LASSO) algorithm to evaluate the risk of NSLN metastasis.Methods: The factors affecting NSLN status were investigated in a cohort of 714 patients with 1-2 positive SLNs treated at The First Affiliated Hospital of Chongqing Medical University between January 2013 and December 2018. A new mathematical prediction model based on the LASSO algorithm was developed and was validated in a cohort of 131 patients treated between January 2019 and December 2019.Results: In the training cohort, 266/714 (37.3%) patients had NSLN metastasis. In univariate analysis, the histologic grade (P =0.010), number of positive SLNs (P<0.001), number of negative SLNs (P<0.001), number of SLNs dissected (P<0.001), SLN metastasis ratio (P <0.001), lymphovascular invasion (LVI) status (P <0.001), estrogen receptor (ER) status (P =0.011), human epidermal growth factor receptor 2 (HER2) status (P =0.005), molecular subtype (P =0.001), and risk score (P <0.001) were related with NSLN involvement. In multivariate analysis, the histologic grade (P =0.026), LVI status (P =0.005), number of positive SLNs (P=0.001), number of negative SLNs (P=0.005), SLN metastasis ratio (P =0.005), and molecular subtype (P=0.007) were identified as the independent predictors of NSLN metastasis. A LASSO regression-based mathematical prediction model was developed and had an area under the curve (AUC) of 0.764 (95% CI: 0.729-0.798). In the 131-patient validation cohort, the AUC was 0.777 (95% CI: 0.692-0.862).Conclusions: We present a new prediction model to assess the risk of NSLN metastasis in Chinese breast cancer patients with 1-2 positive SLNs. The model was further validated in the validation cohort and showed excellent clinical applicability and diagnostic performance. It can be used as an intraoperative clinical tool for clinicians to predict the risk of NSLN metastasis and make the final decision regarding axillary lymph node dissection (ALND).

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Predicting Non‐sentinel Lymph Node Metastasis in a Chinese Breast Cancer Population with 1–2 Positive Sentinel Nodes: Development and Assessment of a New Predictive Nomogram

Abstract: The SCC-NSLN nomogram could serve as an acceptable clinical tool in clinical discussions with patients. The omission of ALND might be possible if the probability of non-SLN involvement is <10 and <15 % in accordance with the acceptable risk determined by medical staff and patients.

Cited by 21 publications

References 43 publications

Can Neutrophil to Lymphocyte Ratio Be a Predictor Tool for The Non-Sentinel Lymph Node Metastasis in Breast Cancer?

Can Neutrophil to Lymphocyte Ratio Be a Predictor Tool for The Non-Sentinel Lymph Node Metastasis in Breast Cancer?

Predictive Factors for Non-Sentinel Lymph Node Metastasis in Patients with ACOSOG Z0011 Criteria

Development of a prediction model based on LASSO regression to evaluate the risk of non-sentinel lymph node metastasis in Chinese breast cancer patients with 1-2 positive sentinel lymph nodes

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