The significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancer
Abstract Objective To explore the high-risk factors affecting the prognosis of pT1 − 2N1M0 patients after mastectomy, establish a nomogram prediction model, and screen the radiotherapy benefit population. Method The clinical data of 936 patients with pT1 − 2N1M0 who underwent mastectomy in the fourt...
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| Format: | Article |
| Language: | English |
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BMC
2024-09-01
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| Series: | Radiation Oncology |
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| Online Access: | https://doi.org/10.1186/s13014-024-02510-w |
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| _version_ | 1832585532546220032 |
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| author | Chao Wei Jie Kong Huina Han Xue Wang Zimeng Gao Danyang Wang Andu Zhang Jun Zhang Zhikun Liu |
| author_facet | Chao Wei Jie Kong Huina Han Xue Wang Zimeng Gao Danyang Wang Andu Zhang Jun Zhang Zhikun Liu |
| author_sort | Chao Wei |
| collection | DOAJ |
| description | Abstract Objective To explore the high-risk factors affecting the prognosis of pT1 − 2N1M0 patients after mastectomy, establish a nomogram prediction model, and screen the radiotherapy benefit population. Method The clinical data of 936 patients with pT1 − 2N1M0 who underwent mastectomy in the fourth hospital of Hebei Medical University from 2010 to 2016 were retrospectively analyzed. There were 583 patients received postmastectomy radiotherapy(PMRT), and 325 patients without PMRT. Group imbalances were mitigated using the propensity score matching (PSM) method, and the log-rank test was employed to compare overall survival (OS) and disease-free survival (DFS) between the cohorts. The efficacy of PMRT across various risk groups was evaluated using a nomogram model. Result The median follow-up period was 98 months, Patients who received PMRT demonstrated significantly improved 5-year and 8-year OS and DFS compared to those who did not (P < 0.001). Multivariate analysis revealed that age, primary tumor site, positive lymph node, stage, and Ki-67 level independently influenced OS, while age, primary tumor site, and stage independently affected DFS. PMRT drastically enhanced OS in the high-risk group (P = 0.001), but did not confer benefits in the low-risk and intermediate risk groups (P = 0.057, P = 0.099). PMRT led to a significant improvement in disease-free survival (DFS) among patients in the intermediate and high-risk groups (P = 0.036, P = 0.001), whereas the low-risk group did not experience a significant benefit (P = 0.475). Conclusion Age ≤ 40 years, tumor located in the inner quadrant or central area, T2 stage, 2–3 lymph nodes metastasis, and Ki67 > 30% were the high-risk factors affecting the prognosis of this cohort of patients. In OS nomogram, patients with a risk score of 149 or higher who received PMRT exhibited improved OS. Similarly, in DFS nomogram, patients with a risk score of 54 or higher who received PMRT demonstrated enhanced DFS. |
| format | Article |
| id | doaj-art-ec727cad78a848d085423c163407223f |
| institution | Kabale University |
| issn | 1748-717X |
| language | English |
| publishDate | 2024-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj-art-ec727cad78a848d085423c163407223f2025-01-26T12:46:01ZengBMCRadiation Oncology1748-717X2024-09-0119111310.1186/s13014-024-02510-wThe significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancerChao Wei0Jie Kong1Huina Han2Xue Wang3Zimeng Gao4Danyang Wang5Andu Zhang6Jun Zhang7Zhikun Liu8Department of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical UniversityAbstract Objective To explore the high-risk factors affecting the prognosis of pT1 − 2N1M0 patients after mastectomy, establish a nomogram prediction model, and screen the radiotherapy benefit population. Method The clinical data of 936 patients with pT1 − 2N1M0 who underwent mastectomy in the fourth hospital of Hebei Medical University from 2010 to 2016 were retrospectively analyzed. There were 583 patients received postmastectomy radiotherapy(PMRT), and 325 patients without PMRT. Group imbalances were mitigated using the propensity score matching (PSM) method, and the log-rank test was employed to compare overall survival (OS) and disease-free survival (DFS) between the cohorts. The efficacy of PMRT across various risk groups was evaluated using a nomogram model. Result The median follow-up period was 98 months, Patients who received PMRT demonstrated significantly improved 5-year and 8-year OS and DFS compared to those who did not (P < 0.001). Multivariate analysis revealed that age, primary tumor site, positive lymph node, stage, and Ki-67 level independently influenced OS, while age, primary tumor site, and stage independently affected DFS. PMRT drastically enhanced OS in the high-risk group (P = 0.001), but did not confer benefits in the low-risk and intermediate risk groups (P = 0.057, P = 0.099). PMRT led to a significant improvement in disease-free survival (DFS) among patients in the intermediate and high-risk groups (P = 0.036, P = 0.001), whereas the low-risk group did not experience a significant benefit (P = 0.475). Conclusion Age ≤ 40 years, tumor located in the inner quadrant or central area, T2 stage, 2–3 lymph nodes metastasis, and Ki67 > 30% were the high-risk factors affecting the prognosis of this cohort of patients. In OS nomogram, patients with a risk score of 149 or higher who received PMRT exhibited improved OS. Similarly, in DFS nomogram, patients with a risk score of 54 or higher who received PMRT demonstrated enhanced DFS.https://doi.org/10.1186/s13014-024-02510-wBreast cancerMastectomypN1PrognosisNomogram modelRadiotherapy |
| spellingShingle | Chao Wei Jie Kong Huina Han Xue Wang Zimeng Gao Danyang Wang Andu Zhang Jun Zhang Zhikun Liu The significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancer Radiation Oncology Breast cancer Mastectomy pN1 Prognosis Nomogram model Radiotherapy |
| title | The significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancer |
| title_full | The significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancer |
| title_fullStr | The significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancer |
| title_full_unstemmed | The significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancer |
| title_short | The significance of risk stratification through nomogram-based assessment in determining postmastectomy radiotherapy for patients diagnosed with pT1 − 2N1M0 breast cancer |
| title_sort | significance of risk stratification through nomogram based assessment in determining postmastectomy radiotherapy for patients diagnosed with pt1 2n1m0 breast cancer |
| topic | Breast cancer Mastectomy pN1 Prognosis Nomogram model Radiotherapy |
| url | https://doi.org/10.1186/s13014-024-02510-w |
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