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- Title
THE VALIDATION OF NOMOGRAMS FOR ESSESING THE NON-SENTINEL LYMPH NODE STATUS IN CLINICALLY NODE NEGATIVE BREAST CANCER PATIENTS.
- Authors
Yildiz, Ramazan; Kilba, Zafer; Peker, Yaşar Subutay; Öztürk, Erkan; MenteĢ, Öner; Görgülü, Semih
- Abstract
INTRODUCTION:-Aim: Axillary-lymph-node dissection (ALND) has been replaced by sentinel-lymph-node- biopsy (SLNB) for early-breast-cancer, Due to current modality; ALND is performed to SLNB+ patients. To avoid performing redundant ALND, nomograms have been constituted. Our aim is to evaluate the relevancy of MSKCC-Tenon-MD.Anderson-Stanford-Turkish nomogram and identify their predictive values. Material-Method: Data of SLNB applied patients between 2007-2013 in our clinic is evaluated retrospectively. The risk rates of MSKCC-Tenon-MD.Anderson-Stanford- Turkish nomogram at SLNB+ patients are identified and ROC-curves are drawn. Area under curves (AUC) is evaluated as the distinctive power of the nomograms. RESULTS: 66/243 patients were found to be SLNB+ and ALND was applied. Only 27(40.9% of SLNB+, 11.1% of SLNB-applied) of ALND applied patients had non-SLN+. AUC values of the nomograms are calculated after ROC curves are drawn. RESULTS: for the nomograms MSKCCTenon- MD.Anderson-Stanford-Turkish nomogram was as written respectively: AUC;0.525-0.520-0.534-0.534-0.605, sensitivity;52.9%-52.9%-55.9%-52.9%-70.5%, specifity; 38.9%-38.9%-55.5%-47.2%-58.3%, positive-predictivevalue; 45%-45%-54.3%-48.6%-61.5%, negative-predictivevalue; 46.7%-46.7%-57.1%-51.5%-67.2%, p-value;0.723- 0.778-0.623-0.627-0.135. DISCUSSION AND CONCLUSION: Accurately evaluating the non-SLNB involvement at SLNB+ patients prevents the patients from excessive-surgery and morbidity. 59.1% of SLNB+ and 88.9%of SLNB-applied patients were found to have no non-SLNB involvement, which shows the importance of nomograms. Non of the nomograms above are strong enough to predict non-SLNB involvement where the best one is „Turkish- nomogram‟. Retrospective analysis of the nomograms indicate us that the predictive parameters for non-SLNB involvement at SLNB positive patients are tumor-size, tumor-type, multiplicity, lymphovascular invasion, grade and number of SLN(s) dissected. In CONCLUSION:, we suggest constituting a new nomogram strong enough with greater number of patients and longterm follow-up duration.
- Publication
Balkan Military Medical Review, 2013, Vol 16, p128
- ISSN
1107-6275
- Publication type
Article