A Nomogram to Predict the Benefit of Radiation Therapy After Breast-Conserving Surgery in Elderly Patients with Stage I & ER-Negative, or Stage II/III Disease

Kai Chen, Fengxi Su, Lisa Jacobs

Research output: Contribution to journalArticle

Abstract

Background: Radiotherapy (RT) may be omitted for elderly (age >70 years) breast cancer patients with favorable disease [stage I and estrogen receptor (ER)-positive with endocrine therapy]. This study sought to develop a nomogram to predict the survival benefit of RT in elderly patients with stage I & ER-negative or stage II/III (regardless of ER status) disease. Methods: We used surveillance, epidemiology and end results data to identify 9,079 patients (age ≥70 years) with stage I & ER-negative or stage II/III (regardless of ER status) disease who received breast-conserving surgery between 1990 and 2005. Cancer-specific survival (CSS) was estimated using Kaplan–Meier analysis. Competing-risk regression was used to determine the effect of predictors on CSS. A nomogram was then developed and validated using bootstrapped technique. Results: With a median follow-up of 83 months, the overall 10- and 15-year CSS were 82.1 and 75.8 %, respectively. RT was significantly associated with improved CSS in the multivariate analysis. A nomogram was developed for the prediction of 10-year CSS and showed a bootstrapped-corrected area under the curve value of 0.679. RT did not deliver any survival benefit to patients with predicted CSS >90 %. In addition, RT significantly increased the 10-year CSS by 3.6 and 10.1 % in patients with predicted CSS from 0.80 to 0.90 and

Original languageEnglish (US)
Pages (from-to)3497-3503
Number of pages7
JournalAnnals of Surgical Oncology
Volume22
Issue number11
DOIs
StatePublished - Oct 15 2015

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Nomograms
Segmental Mastectomy
Estrogen Receptors
Radiotherapy
Survival
Neoplasms
Area Under Curve
Epidemiology
Multivariate Analysis
Breast Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

@article{e80c20e1e0d345de9551391c60d7eac9,
title = "A Nomogram to Predict the Benefit of Radiation Therapy After Breast-Conserving Surgery in Elderly Patients with Stage I & ER-Negative, or Stage II/III Disease",
abstract = "Background: Radiotherapy (RT) may be omitted for elderly (age >70 years) breast cancer patients with favorable disease [stage I and estrogen receptor (ER)-positive with endocrine therapy]. This study sought to develop a nomogram to predict the survival benefit of RT in elderly patients with stage I & ER-negative or stage II/III (regardless of ER status) disease. Methods: We used surveillance, epidemiology and end results data to identify 9,079 patients (age ≥70 years) with stage I & ER-negative or stage II/III (regardless of ER status) disease who received breast-conserving surgery between 1990 and 2005. Cancer-specific survival (CSS) was estimated using Kaplan–Meier analysis. Competing-risk regression was used to determine the effect of predictors on CSS. A nomogram was then developed and validated using bootstrapped technique. Results: With a median follow-up of 83 months, the overall 10- and 15-year CSS were 82.1 and 75.8 {\%}, respectively. RT was significantly associated with improved CSS in the multivariate analysis. A nomogram was developed for the prediction of 10-year CSS and showed a bootstrapped-corrected area under the curve value of 0.679. RT did not deliver any survival benefit to patients with predicted CSS >90 {\%}. In addition, RT significantly increased the 10-year CSS by 3.6 and 10.1 {\%} in patients with predicted CSS from 0.80 to 0.90 and",
author = "Kai Chen and Fengxi Su and Lisa Jacobs",
year = "2015",
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day = "15",
doi = "10.1245/s10434-015-4393-7",
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T1 - A Nomogram to Predict the Benefit of Radiation Therapy After Breast-Conserving Surgery in Elderly Patients with Stage I & ER-Negative, or Stage II/III Disease

AU - Chen, Kai

AU - Su, Fengxi

AU - Jacobs, Lisa

PY - 2015/10/15

Y1 - 2015/10/15

N2 - Background: Radiotherapy (RT) may be omitted for elderly (age >70 years) breast cancer patients with favorable disease [stage I and estrogen receptor (ER)-positive with endocrine therapy]. This study sought to develop a nomogram to predict the survival benefit of RT in elderly patients with stage I & ER-negative or stage II/III (regardless of ER status) disease. Methods: We used surveillance, epidemiology and end results data to identify 9,079 patients (age ≥70 years) with stage I & ER-negative or stage II/III (regardless of ER status) disease who received breast-conserving surgery between 1990 and 2005. Cancer-specific survival (CSS) was estimated using Kaplan–Meier analysis. Competing-risk regression was used to determine the effect of predictors on CSS. A nomogram was then developed and validated using bootstrapped technique. Results: With a median follow-up of 83 months, the overall 10- and 15-year CSS were 82.1 and 75.8 %, respectively. RT was significantly associated with improved CSS in the multivariate analysis. A nomogram was developed for the prediction of 10-year CSS and showed a bootstrapped-corrected area under the curve value of 0.679. RT did not deliver any survival benefit to patients with predicted CSS >90 %. In addition, RT significantly increased the 10-year CSS by 3.6 and 10.1 % in patients with predicted CSS from 0.80 to 0.90 and

AB - Background: Radiotherapy (RT) may be omitted for elderly (age >70 years) breast cancer patients with favorable disease [stage I and estrogen receptor (ER)-positive with endocrine therapy]. This study sought to develop a nomogram to predict the survival benefit of RT in elderly patients with stage I & ER-negative or stage II/III (regardless of ER status) disease. Methods: We used surveillance, epidemiology and end results data to identify 9,079 patients (age ≥70 years) with stage I & ER-negative or stage II/III (regardless of ER status) disease who received breast-conserving surgery between 1990 and 2005. Cancer-specific survival (CSS) was estimated using Kaplan–Meier analysis. Competing-risk regression was used to determine the effect of predictors on CSS. A nomogram was then developed and validated using bootstrapped technique. Results: With a median follow-up of 83 months, the overall 10- and 15-year CSS were 82.1 and 75.8 %, respectively. RT was significantly associated with improved CSS in the multivariate analysis. A nomogram was developed for the prediction of 10-year CSS and showed a bootstrapped-corrected area under the curve value of 0.679. RT did not deliver any survival benefit to patients with predicted CSS >90 %. In addition, RT significantly increased the 10-year CSS by 3.6 and 10.1 % in patients with predicted CSS from 0.80 to 0.90 and

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