The Nottingham Prognostic Index: five- and ten-year data for all-cause Survival within a Screened Population

Fong, Yoke Fai; Evans, Jane C.; Brook, D.; Kenkre, Joyce; Jarvis, Paul; Gower-Thomas, K

doi:10.1308/003588414x14055925060514

Cited by 52 publications

(39 citation statements)

References 14 publications

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“…Typically, the measurement of the breast cancer size is performed as linear measurements in two spatial dimensions. Both the NPI and the T-staging are based on this method 5,8,25 . The breast carcinoma may grow in a diffuse pattern, as is often observed in invasive lobular subtypes 39 .…”

Section: Discussionmentioning

confidence: 99%

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Automated volumetric radiomic analysis of breast cancer vascularization improves survival prediction in primary breast cancer

Dietzel

Schulz‐Wendtland

Ellmann

et al. 2020

Sci Rep

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to investigate whether automated volumetric radiomic analysis of breast cancer vascularization (VAV) can improve survival prediction in primary breast cancer. 314 consecutive patients with primary invasive breast cancer received standard clinical MRi before the initiation of treatment according to international recommendations. Diagnostic work-up, treatment, and follow-up was done at one tertiary care, academic breast-center (outcome: disease specific survival/DSS vs. disease specific death/ DSD). the nottingham prognostic index (npi) was used as the reference method with which to predict survival of breast cancer. Based on the MRi scans, VAV was accomplished by commercially available, fDA-cleared software. DSD served as endpoint. integration of VAV into the npi gave npi VAV. prediction of DSD by npi VAV compared to standard npi alone was investigated (cox regression, likelihood-test, predictive accuracy: Harrell's C, Kaplan Meier statistics and corresponding hazard ratios/HR, confidence intervals/CI). DSD occurred in 35 and DSS in 279 patients. Prognostication of the survival outcome by npi (Harrell's c = 75.3%) was enhanced by VAV (NPI VAV : Harrell's c = 81.0%). Most of all, the NPI VAV identified patients with unfavourable outcome more reliably than NPI alone (hazard ratio/HR = 4.5; confidence interval/CI = 2.14-9.58; P = 0.0001). Automated volumetric radiomic analysis of breast cancer vascularization improved survival prediction in primary breast cancer. Most of all, it optimized the identification of patients at higher risk of an unfavorable outcome. Future studies should integrate MRi as a "gate keeper" in the management of breast cancer patients. Such a "gate keeper" could assist in selecting patients benefitting from more advanced diagnostic procedures (genetic profiling etc.) in order to decide whether are a more aggressive therapy (chemotherapy) is warranted. Breast cancer is the most common malignant neoplasm of women in the western world. Despite substantial advances in diagnosis and treatment, morbidity and mortality of breast cancer remain high 1. By adjusting the treatment to the individual cancer biology, precision medicine aims to both improve disease survival and to reduce the rate of unnecessary cytotoxic treatment 2,3. To achieve this goal, accurate biomarkers are essential tools for precision medicine. They help us to understand tumor biology and allow estimation of patient outcome 4. The Nottingham Prognostic Index (NPI) is a well-established and widely used method for the prediction of survival of primary breast cancer. It is based on three classic biomarkers of breast cancer: tumor size, tumor grade, and the number of metastatic loco-regional lymph nodes 5-8. Breast MRI (MRI) is a functional imaging method that has been validated in clinical practice for over 30 years 9. Objective semi-quantitative analysis of MRI by automated, FDA-cleared software has been intensely

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Section: Discussionmentioning

confidence: 99%

“…The literature reports a large number of breast cancer biomarkers. Hereby, the NPI was introduced in 1982 and remains a widely used method to predict survival in primary breast cancer 5,6,8 . A completely different approach is taken by multigene assays.…”

Section: Discussionmentioning

confidence: 99%

Automated volumetric radiomic analysis of breast cancer vascularization improves survival prediction in primary breast cancer

Dietzel

Schulz‐Wendtland

Ellmann

et al. 2020

Sci Rep

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“…Information was available for all patients' tumour size, number of positive lymph nodes, histological grade. NPI was calculated for each of the patients by using the following equation: NPI = 0.2 × tumour size (cm) + grade (1-3) + lymph node status (1-3) (Fong et al, 2015). Patients were grouped into four categories according to the NPI score: I (excellent) ≤2.4; II (good) >2.4 but ≤3.4; III (moderate) >3.4 but ≤5.4; and IV (poor) >5.4.…”

Section: Methodsmentioning

confidence: 99%

Nottingham Prognostic Index is an Applicable Prognostic Tool in Non-Metastatic Triple-Negative Breast Cancer

Jarroudi¹,

Zaimi²,

Brahmi³

et al. 2019

Asian Pac J Cancer Prev

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Introduction: Triple-negative breast cancer (TNBC) is characterized by a poor prognosis due to high mortality and early relapse, requiring the study of its prognostic factors. Tumor size, histological grade and lymph node status represent important parameters that are widely studied in breast cancer, and are retained as prognostic factors by several international guidelines. The Nottingham team combined these parameters into a prognostic score called the Nottingham prognostic index (NPI). In this study, we investigated the influence of NPI on outcomes in non metastatic TNBC. Methodology: This retrospective cohort study included all female patients with non metastatic TNBC who received treatment at the Regional Oncology Center Hassan II Oujda-Morocco, between January 2009 and December 2011. The prognostic impact of the NPI on the survival curves at 5 years was studied using multivariate Cox proportional hazards models. Results: The analysis of the data involved 98 patients, 39 patients (39.8%) were classed in the poor prognosis group with a NPI > 5.4. The Overall survival (OS) and Disease free survival (DFS) rates at 5 years, in this group, were 70 and 55.6 % respectively. After adjusting for clinic-pathological variables, a NPI > 5.4 was associated with mortality (HR: 2.598, 95% CI: 1.423-4.744, p = 0.002) and disease progression (HR: 2.512, CI to 95%: 1.496-4.219, p <0.001) in patients with non-metastatic TNBC. Conclusion: This retrospective cohort analysis showed that NPI was an independent prognostic factor for OS and DFS at 5 years in women with non metastatic TNBC. Once validated, the impact of this score on survival outcomes could be considered in the clinical management of TNBC.

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“…In Supplementary Figure 1, the breast cancer staging was 11.22% for stage I, 59.18% for stage II, 29.60% for stage III. The Nottingham prognostic index (NPI) is an established prognostication tool for the management of breast cancers (Fong et al, 2015). The majority of patients were classified as moderate Nottingham prognostic index (107 patients, 54.9%).…”

Section: Patient and Tumour Characteristics Of Breast Cancer Patientsmentioning

confidence: 99%

Correlation between HER2 Expression and Clinicopathological Features of Breast Cancer: A Cross- Sectional Study in Vietnam

Cong

Nguyễn-Thanh

Phan

et al. 2020

Asian Pac J Cancer Prev

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Background: HER2 is the target of the therapeutic agents which are used to treat HER2-positive breast cancer. Reports have shown that the HER2 oncogene expression and its association with clinicopathological factors remain unclear in breast cancer (BC) patients. This study aimed to determine the correlation between HER2 expression and clinicalpathological characteristics of breast cancer in Vietnamese women. Methods: Between June 2016 and August 2018, paraffin-embedded specimens from 237 patients with primary invasive breast carcinoma in Hue University Hospital and Hue Center Hospital, Hue city, Vietnam were examined for pathological features. The gene expression of HER2, ER, PR and Ki-67 were determined by immunohistochemistry (IHC). The gene amplification of Her2 was assessed by using Dual color in situ hybridization (DISH). Results: The most frequent histological type was invasive carcinoma of no special type (NST) with 77.35%, the highest percentage of patients with Grade II was detected (59.36%), tumor size > 2 cm accounted for 71.31% of cases, Lymph node metastases were available in 57.86% cases. Most patients were diagnosed at stage II (59.18%). The majority of patients were classified as moderate Nottingham prognostic index (54.9%). Estrogen receptor and Progesterone receptor were positive in 53.16% and 50.63%, respectively. 76.37% of cases were in high expression group of Ki-67 (≥14%). HER2 IHC 2+, 3+ were accounted for 28.69% and HER2 gene amplification was detected in 31% cases. HER2 gene amplification and/or overexpression was significantly associated with cell proliferation index Ki67. Furthermore, HER2 gene expression tended to be more frequently found in tumors with large tumor size, high grade, high stage and high Nottingham prognostic index and confirmed their prognostic independent role. Conclusions: Our data indicated that HER2 gene expression was significantly correlated with cell proliferation index Ki67, but not significantly associated with another clinicopathological factors in breast cancer of Vietnamese women.

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The Nottingham Prognostic Index: five- and ten-year data for all-cause Survival within a Screened Population

Cited by 52 publications

References 14 publications

Automated volumetric radiomic analysis of breast cancer vascularization improves survival prediction in primary breast cancer

Automated volumetric radiomic analysis of breast cancer vascularization improves survival prediction in primary breast cancer

Nottingham Prognostic Index is an Applicable Prognostic Tool in Non-Metastatic Triple-Negative Breast Cancer

Correlation between HER2 Expression and Clinicopathological Features of Breast Cancer: A Cross- Sectional Study in Vietnam

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