External validation of a prognostic model based on total tumor load of sentinel lymph node for early breast cancer patients
Entity
UAM. Departamento de Obstetricia y Ginecología; Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)Publisher
Springer NatureDate
2020-04-06Citation
10.1007/s10549-020-05623-4
Breast Cancer Research and Treatment 181.2 (2020): 339-345
ISSN
0167-6806 (print); 1573-7217 (online)DOI
10.1007/s10549-020-05623-4Funded by
This study was supported by Sysmex España S.L.Editor's Version
http://doi.org/10.1007/s10549-020-05623-4Subjects
Breast cancer; Model validation; Prognosis; Sentinel lymph node; Total tumor load; MedicinaRights
© 2020 The AuthorsAbstract
Background: A prognostic model based on the results of molecular analysis of sentinel lymph nodes (SLN) is needed to replace the information that staging the entire axilla provided. The aim of the study is to conduct an external validation of a previously developed model for the prediction of 5-year DFS in a group of breast cancer patients that had undergone SLN biopsy assessed by the One Step Nucleic Acid Amplification (OSNA) method. Methods: We collected retrospective data of 889 patients with breast cancer, who had not received systemic treatment before surgery, and who underwent SLN biopsy and evaluation of all SLN by OSNA. The discrimination ability of the model was assessed by the area under the ROC curve (AUC ROC), and its calibration by comparing 5-years DFS Kaplan–Meier estimates in quartile groups of model predicted probabilities (MPP). Results: The AUC ROC ranged from 0.78 (at 2 years) to 0.73 (at 5 years) in the training set, and from 0.78 to 0.71, respectively, in the validation set. The MPP allowed to distinguish four groups of patients with heterogeneous DFS (log-rank test p < 0.0001). In the highest risk group, the HR were 6.04 [95% CI 2.70, 13.48] in the training set and 4.79 [2.310, 9.93] in the validation set. Conclusions: The model for the prediction of 5-year DFS was successfully validated using the most stringent form of validation, in centers different from those involved in the development of the model. The external validation of the model confirms its utility for the prediction of 5-year DFS and the usefulness of the TTL value as a prognostic variable.
Files in this item
Google Scholar:Piñero-Madrona, Antonio
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Ripoll-Orts, Francisco
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Sánchez Méndez, José Ignacio
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Chaves-Benito, Asunción
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Gómez-de la Bárcena, Maximiliano Rodrigo
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Calatrava-Fons, Ana
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Menjón-Beltrán, Salomón
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Peg-Cámara, Vicente
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