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Nomogram for predicting axillary upstaging in clinical node-negative breast cancer patients receiving neoadjuvant chemotherapy

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收录情况： ◇ SCIE

作者：
Maimaitiaili Amina[1] * ; Chen Heyan[1] ; Xie Peiling[1] ; Liu Zhenzhen[2] ; Ling Rui[3] ; Zhao Yi[4] ; Yang Hongjian[5] ; Liu Yunjiang[6] ; Liu Ke[7] ; Zhang Jianguo[8] ; Mao Dahua[9] ; Yu Zhigang[10] ; Liu Yinhua[11] ; Fu Peifen[12] ; Wang Jiandong[13] ; Jiang Hongchuan[14] ; Zhao Zuowei[15] ; Tian Xingsong[16] ; Cao Zhongwei[17] ; Wu Kejin[18] ; Song Ailin[19] ; Jin Feng[20] ; He Jianjun[1] ; Fan Zhimin[21] ; Zhang Huimin[1] ;
机构： [1]Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi Province, China. [2]Department of Breast Disease, Henan Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Dongming Road, Zhengzhou, 450008, Henan Province, China. [3]Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China. [4]Surgical Oncology Department, Shengjing Hospital of China Medical University, Shenyang, 110022, Liaoning Province, China. [5]Department of Breast Surgery, Institute of Basic Medicine and Cancer (IBMC), The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Chinese Academy of Sciences, Hangzhou, 310022, Zhejiang Province, China. [6]Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 052360, Hebei Province, China. [7]Fourth Department of Breast Surgery, Jilin Cancer Hospital, Changchun, 130012, Jilin Province, China. [8]Department of Breast Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, Heilongjiang Province, China. [9]Department of Breast Surgery, Affiliated Wudang Hospital of Guizhou Medical University, Guiyang, 550009, Guizhou Province, China. [10]Department of Breast Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, Shandong Province, China. [11]Breast Disease Center, Peking University First Hospital, Beijing, 100034, China. [12]Department of Breast Surgery, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China. [13]Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing, 100852, China. [14]Department of Breast Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China. [15]Department of Breast Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, Liaoning Province, China. [16]Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, Shandong Province, China. [17]Department of Thyroid, Breast, Hernia Surgery, The Inner Mongolia Autonomous Region People's Hospital, Hohhot, 010017, Inner Mongolia Autonomous Region, China. [18]Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200433, China. [19]Department of General Surgery, Lanzhou University Second Hospital, Lanzhou, 730000, Gansu Province, China. [20]Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, 110002, Liaoning Province, China. [21]Department of Breast Surgery, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, Jilin Province, China
出处：
DOI： 10.1007/s00432-023-04817-9
ISSN：

关键词： Breast cancer Clinical lymph node negative Neoadjuvant chemotherapy Axillary upstaging Prediction nomogram

摘要：
The prediction of axillary lymph node status after neoadjuvant chemotherapy (NAC) becoming critical because of the advocation of the de-escalation of axillary management. We investigate associated factors of axillary upstaging in clinical node-negative (cN0) breast cancer patients receiving NAC to develop and validate an accurate prediction nomogram.We retrospectively analyzed 1892 breast cancer patients with stage of cT1-3N0 treated by NAC and subsequent surgery between 2010 and 2020 in twenty hospitals across China. Patients randomly divided into a training set and validation set (3:1). Univariate and multivariate logistic regression analysis were performed, after which a nomogram was constructed and validated.In total, pathologic node negativity (ypN0) achieved in 1406 (74.3%) patients and another 486 (25.7%) patients upstaged to pathologic node positive (ypN+). Breast pathologic complete response (bpCR) was achieved in 445 (23.5%) patients and non-bpCR in 1447 (76.5%) patients. A nomogram was established by ER, tumor histology, HER2 status, cycle of NAC treatment, and the bpCR, which were confirmed by multivariate logistic analysis as independent predictors of nodal upstaging in the training cohort (n = 1419). The area under the receiver operating characteristic curve (AUC) of the training cohort and validation cohort (n = 473) were 0.73 (95% CI 0.693-0.751) and 0.77 (95% CI 0.723-0.812) respectively.We present a nomogram with a nationwide large sample data which can effectively predict axillary upstaging after neoadjuvant chemotherapy to give better advice for individualized axillary lymph node management of breast cancer.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

基金：
Institutional Foundation of The First Affiliated Hospital of Xi’an Jiaotong University (2022YQPY08)
语种：
外文
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PubmedID：
中科院分区：
出版当年[2023]版：
大类 | 3 区 医学
小类 | 4 区 肿瘤学
最新[2025]版：
大类 | 4 区 医学
小类 | 4 区 肿瘤学
JCR分区：
出版当年[2023]版：
Q3 ONCOLOGY
最新[2023]版：
Q3 ONCOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

第一作者：
第一作者机构： [1]Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi Province, China.
通讯作者：
推荐引用方式(GB/T 7714)：
Maimaitiaili Amina,Chen Heyan,Xie Peiling,et al.Nomogram for predicting axillary upstaging in clinical node-negative breast cancer patients receiving neoadjuvant chemotherapy[J].JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY.2023,149(11):8769-8778.doi:10.1007/s00432-023-04817-9.
APA：
Maimaitiaili Amina,Chen Heyan,Xie Peiling,Liu Zhenzhen,Ling Rui...&Zhang Huimin.(2023).Nomogram for predicting axillary upstaging in clinical node-negative breast cancer patients receiving neoadjuvant chemotherapy.JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY,149,(11)
MLA：
Maimaitiaili Amina,et al."Nomogram for predicting axillary upstaging in clinical node-negative breast cancer patients receiving neoadjuvant chemotherapy".JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 149..11(2023):8769-8778

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