AI Article Synopsis
- - The study investigates the factors that affect survival outcomes in patients with pTNM staging after mastectomy, aiming to create a prediction model and identify which patients benefit from postmastectomy radiotherapy (PMRT).
- - Researchers analyzed data from 936 patients, revealing that those who received PMRT had significantly better overall survival (OS) and disease-free survival (DFS) after surgery, especially in high-risk groups, while low and intermediate-risk groups did not show the same benefits.
- - Key high-risk factors identified included age under 40, tumor location, lymph node involvement, and a specific Ki-67 level, highlighting that certain patients (with a risk score ≥149) who received PMRT experienced notable improvements in
Article Abstract
Objective: To explore the high-risk factors affecting the prognosis of pTNM patients after mastectomy, establish a nomogram prediction model, and screen the radiotherapy benefit population.
Method: The clinical data of 936 patients with pTNM 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, T 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 123 or higher who received PMRT demonstrated enhanced DFS.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11396491 | PMC |
| http://dx.doi.org/10.1186/s13014-024-02510-w | DOI Listing |
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