Oncotarget

Research Papers:

A prognostic score model to determine which breast cancer patients with 1–3 positive lymph nodes after modified radical mastectomy should receive radiotherapy

Dawei Chen, Haiyong Wang, Xinyu Song, Fang Shi, Li Kong _ and Jinming Yu

PDF  |  HTML  |  Supplementary Files  |  How to cite

Oncotarget. 2018; 9:385-393. https://doi.org/10.18632/oncotarget.21531

Metrics: PDF 1606 views  |   HTML 2237 views  |   ?  


Abstract

Dawei Chen1,*, Haiyong Wang2,*, Xinyu Song1,3, Fang Shi1, Li Kong1 and Jinming Yu1

1Department of Radiation Oncology, Shandong Cancer Hospital affiliated with Shandong University, Shandong Academy of Medical Sciences, Shandong, China

2Department of Internal Medicine-Oncology, Shandong Cancer Hospital affiliated with Shandong University, Shandong Academy of Medical Sciences, Shandong, China

3School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong, China

*These authors contributed equally to this work

Correspondence to:

Li Kong, email: [email protected]

Jinming Yu, email: [email protected]

Keywords: breast cancer, postmastectomy radiotherapy, SEER, population-based study

Received: July 03, 2017     Accepted: September 20, 2017     Published: October 05, 2017

ABSTRACT

There is no consensus on the indication for postmastectomy radiotherapy (PMRT) in breast cancer patients with one to three positive lymph nodes. To identify patients for whom PMRT may be indicated, we used a prognostic score model with the SEER database to retrospectively analyze 8049 patients with one to three positive lymph nodes who underwent mastectomy with or without PMRT between 2010 and 2013. Kaplan-Meier analysis showed that PMRT patients had better overall survival (OS) than no-PMRT patients (P < 0.001); however, there was no difference in cancer-specific survival (CSS) (P = 0.530). Multivariate analysis with Cox regression showed that grade (P < 0.001), tumor size (P < 0.001), and progesterone receptor status (P < 0.001) were independent prognostic factors for OS. To diminish bias, we used 1:1 propensity score matching analysis and prognosis score model, which revealed that PMRT patients had better OS and CSS than no-PMRT patients (P < 0.001). In a concrete subgroup analysis of PMRT patients, significant improvements in OS were observed in patients scoring 0, 1, or 2. PMRT patients scoring 2 also had improved CSS. The magnitude of the OS and CSS difference with PMRT correlated with the prognostic score (P < 0.001). These results suggest PMRT in breast cancer patients with one to three positive lymph nodes should be based on patient factors, tumor biology, and prognostic score.


Creative Commons License All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 License.
PII: 21531