Establishment and Verification of a Predictive Model for Node Pathological Complete Response After Neoadjuvant Chemotherapy for Initial Node Positive Early Breast Cancer

Frontiers in Oncology

Haibo Wang¹  Cuizhi Geng²  Yongmei Yin³  Peifen Fu⁴  Xianfu Sun⁵  Xuhui Guo⁵  Zhenzhen Liu⁵  Zhenduo Lu⁵  Lianfang Li⁵  Shude Cui⁵  Jianghua Qiao⁵  Chongjian Zhang⁵  Li Qin⁵  Xiuchun Chen⁵  Chengzheng Wang⁵  Dechuang Jiao⁵  Jiujun Zhu⁵  Min Yan⁵  Jianbin Li⁶  Zefei Jiang⁶  Zhimin Fan⁷  Feng Jin⁸  Jianguo Zhang⁹ 

[1] Department of Breast Cancer Center, Affiliated Hospital of Medical College Qingdao University, Qingdao, China;Department of Breast Cancer Center, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China;Department of Breast Cancer, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China;Department of Breast Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China;Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China;Department of Breast Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China;Department of Breast Surgery, The First Hospital of Jilin University, Changchun, China;Department of Breast Surgery, The First affiliated Hospital of China Medical University, Shenyang, China;Department of Breast Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China;

关键词: breast neoplasm;    lymph node;    pathological complete response;    predictive model;    neoadjuvant chemotherapy (NCT);   

DOI  :  10.3389/fonc.2021.675070

来源: DOAJ

【 摘 要 】

ObjectiveAxillary node status after neoadjuvant chemotherapy (NCT) in early breast cancer patients influences the axillary surgical staging procedure. This study was conducted for the identification of the likelihood of patients being node pathological complete response (pCR) post NCT. We aimed to recognize patients most likely to benefit from sentinel lymph node biopsy (SLNB) following NCT and to reduce the risk of missed detection of positive lymph nodes through the construction and validation of a clinical preoperative scoring prediction model.MethodsThe existing data (from March 2010 to December 2018) of the Chinese Society of Clinical Oncology Breast Cancer Database (CSCO-BC) was used to evaluate the independent related factors of node pCR after NCT by Binary Logistic Regression analysis. A predictive model was established according to the score of considerable factors to identify ypN0. Model performance was confirmed in a cohort of NCT patients treated between January 2019 and December 2019 in Henan Cancer Hospital, and model discrimination was evaluated via assessing the area under the receiver operating characteristic (ROC) curve (AUC).ResultsMultivariate regression analysis showed that the node stage before chemotherapy, the expression level of Ki-67, biologic subtype, and breast pCR were all independent related factors of ypN0 after chemotherapy. According to the transformation and summation of odds ratio (OR) values of each variable, the scoring system model was constructed with a total score of 1–5. The AUC for the ROC curves was 0.715 and 0.770 for the training and the validation set accordingly.ConclusionsA model was established and verified for predicting ypN0 after chemotherapy in newly diagnosed cN+ patients and the model had good accuracy and efficacy. The underlined effective model can suggest axillary surgical planning, and reduce the risk of missing positive lymph nodes by SLNB after NCT. It has great value for identifying initial cN+ patients who are more appropriate for SLNB post-chemotherapy.

【 授权许可】

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