title: Validation and comparison of CS-IHC4 scores with a nomogram to predict recurrence in hormone receptor-positive breast cancers.
abstract: The aim of this study was to both develop and validate a nomogram based on the Ki-67 index to predict recurrence. We constructed a nomogram using the Cox proportional hazards model with 953 N0 and N1 postoperative hormone receptor (HR)-positive breast cancer patients and validated it in an external cohort of 895 patients. A prognostic model that used classical variables, Adjuvant! Online, St. Gallen risk stratification, and the four immunohistochemistry (IHC) markers (IHC4 score) was created and assessed by the likelihood ratio χ(2) (LR-χ(2)) test using the bootstrapping method. The nomogram showed an area under the receiver operating characteristic curve (AUC) of 0.75 (95% CI 0.72-0.77) in the training set. The validation set showed good discrimination with an AUC of 0.63 (95% CI 0.60-0.66). In the LR-χ(2) test, the nomogram score was found to be more informative than the IHC4 with clinical score (CS) [LR-χ(2) 13.365 (1 d.f.); 95% CI 2.50-24.23 for CS-IHC4 + nomogram score vs. CS-IHC4] on distant recurrence-free survival. This study implies that the amount of prognostic information contained in the nomogram is superior to that in the CS-IHC4 score in HR-positive N0 and N1 breast cancer patients (NCT1273415).
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Yeon Hee
authors.initials: YH
authors.lastname: Park
authors.forename: Seock-Ah
authors.initials: SA
authors.lastname: Im
authors.forename: Eun Yoon
authors.initials: EY
authors.lastname: Cho
authors.forename: Joong Hyun
authors.initials: JH
authors.lastname: Ahn
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Woo
authors.forename: Seonwoo
authors.initials: S
authors.lastname: Kim
authors.forename: Bhumsuk
authors.initials: B
authors.lastname: Keam
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
authors.forename: Wonshik
authors.initials: W
authors.lastname: Han
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
authors.forename: In Ae
authors.initials: IA
authors.lastname: Park
authors.forename: Dong-Young
authors.initials: DY
authors.lastname: Noh
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Yang
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Ahn
authors.forename: Young-Hyuck
authors.initials: YH
authors.lastname: Im
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000378:metabolism; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D009376:Neoplasms, Hormone-Dependent / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D049451:Nomograms; D016016:Proportional Hazards Models; D012372:ROC Curve; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone