Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2018.0274

Original Article

Validation of the Memorial Sloan-Kettering Cancer Center nomogram in the prediction of recurrence risk after treatment in Ductal Carcinoma in Situ of the breast.

Carolina de la Pinta1, Eva Fernández-Lizarbe1, Alfonso Muriel2, Belen Pérez3, Mercedes Martín1, Teresa Muñóz1, Raúl Hernánz1, Ángel Montero4, Sonsoles Sancho1.

Affiliation:
1Hospital Ramón y Cajal, Radiation Oncology, Madrid, Spain.
2Hospital Ramón y Cajal, Statistical Department, Madrid, Spain.
3Hospital Ramón y Cajal, Pathological Department, Madrid, Spain.
4HM Madrid, Radiation Oncology, Madrid, Spain.

E-mail: eva.lizarbe@gmail.com

Abstract
Purpose
Prediction of patients at highest risk for ipsilateral breast tumor recurrence (IBTR) after local excision of ductal carcinoma in situ (DCIS) remains a clinical concern. The aim of our study was to evaluate the nomogram from Memorial Sloan Kettering Cancer Center (MSKCC) to predict the risk of IBTR in a Spanish population with DCIS in our institution.
Patients and Methods
We retrospectively identified 307 patients diagnosed of DCIS who had undergone surgery from 2000 through 2011 at the Ramón y Cajal University Hospital (Madrid). Clinic and pathologic factors and performance of the MSKCC nomogram for prediction of IBTR were assessed.
Results
Median follow-up time was 112 months. Among the 306 patients, 50 (16.33%) developed recurrence. IBTR was present in 38 patients (12.41%), 20 of those had DCIS and 18 had invasive recurrence. We evaluated our data set with the MSKCC model. Because of missing data, 1 of the 306 patients was excluded. The 5- and 10-year probabilities of recurrence for the 305 patients who had complete data were calculated with the MSKCC nomogram. Only patients with ipsilateral recurrence were included in our validation. Calibration for 5- and 10- year probability of breast recurrence for the nomogram showed good model calibration with intermediate correlation of nomogram-predicted probability of breast recurrence and observed probability of breast recurrence as estimated by the Kaplan-Meier method. The best correlation was in terciles. We have stratified patients in three groups: low risk as < 5% of risk of recurrence, intermediate risk between 6-10% and high risk with > 11%.
Conclusions
The MSKCC nomogram shows validity in our population and allows users to integrate the information from 10 different variables to provide precise risk stratification. We have validated the MSKCC nomogram in our Spanish population and we are considering new lines of study.

(Citation: Gastric & Breast Cancer 2018; 13(1): 21-30)

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last update: 31 March 2018