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Validation of a nomogram for predicting the risk of lymphedema following contemporary treatment for breast cancer: a large multi-institutional study (KROG 20-05)

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Author(s)
Hwa Kyung ByunJae Sik KimJee Suk ChangYeona ChoSung-Ja AhnJung Han YoonHaeyoung KimNalee KimEuncheol ChoiHyeli ParkKyubo KimShin-Hyung ParkChai Hong RimHoon Sik ChoiYoon Kyeong OhIk Jae LeeKyung Hwan ShinYong Bae Kim
Keimyung Author(s)
Choi, Eun Cheol
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Breast Cancer Res Treat
Issued Date
2022
Volume
192
Keyword
Breast cancerContemporary treatmentLymphedemaNomogram
Abstract
Purpose:
We previously constructed a nomogram for predicting the risk of arm lymphedema following contemporary breast cancer treatment. This nomogram should be validated in patients with different background characteristics before use. Therefore, we aimed to externally validate the nomogram in a large multi-institutional cohort.

Methods:
Overall, 8835 patients who underwent breast cancer surgery during 2007–2017 were identified. Data of variables in the nomogram and arm lymphedema were collected. The nomogram was validated externally using C-index and integrated area under the curve (iAUC) with 1000 bootstrap samples and by calibration plots.

Results:
Overall, 1377 patients (15.6%) developed lymphedema. The median time from surgery to lymphedema development was 11.4 months. Lymphedema rates at 2, 3, and 5 years were 11.2%, 13.1%, and 15.6%, respectively. Patients with lymphedema had significantly higher body mass index (median, 24.1 kg/m2 vs. 23.4 kg/m2) and a greater number of removed nodes (median, 17 vs. 6) and more frequently underwent taxane-based chemotherapy (85.7% vs. 41.9%), total mastectomy (73.1% vs. 52.1%), conventionally fractionated radiotherapy (71.9% vs. 54.2%), and regional nodal irradiation (70.7% vs 22.4%) than those who did not develop lymphedema (all P < 0.001). The C-index of the nomogram was 0.7887, and iAUC was 0.7628, indicating good predictive accuracy. Calibration plots confirmed that the predicted lymphedema risks were well correlated with the actual lymphedema rates.

Conclusion:
This nomogram, which was developed using factors related to multimodal breast cancer treatment and was validated in a large multi-institutional cohort, can well predict the risk of breast cancer-related lymphedema.
Keimyung Author(s)(Kor)
최은철
Publisher
School of Medicine (의과대학)
Citation
Hwa Kyung Byun et al. (2022). Validation of a nomogram for predicting the risk of lymphedema following contemporary treatment for breast cancer: a large multi-institutional study (KROG 20-05). Breast Cancer Res Treat, 192, 553–561. doi: 10.1007/s10549-021-06507-x
Type
Article
ISSN
1573-7217
Source
https://link.springer.com/article/10.1007/s10549-021-06507-x
DOI
10.1007/s10549-021-06507-x
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44174
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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