Analysis of Local Recurrence Risk in Ductal Carcinoma In Situ and External Validation of the Memorial Sloan Kettering Cancer Center Nomogram

Author:

Oses Gabriela1,Mension Eduard2ORCID,Pumarola Claudia2,Castillo Helena2,Francesc León1,Torras Inés2,Cebrecos Isaac2ORCID,Caparrós Xavier2,Ganau Sergi3ORCID,Ubeda Belén3,Bargallo Xavier3,González Blanca4,Sanfeliu Esther4ORCID,Vidal-Sicart Sergi5,Moreno Reinaldo6,Muñoz Montserrat6,Santamaría Gorane7ORCID,Mollà Meritxell1ORCID

Affiliation:

1. Department of Radiation Oncology, Hospital Clínic of Barcelona, 08036 Barcelona, Spain

2. Department of Obstetrics and Gynecology, Hospital Clínic of Barcelona, 08036 Barcelona, Spain

3. Department of Radiology, Hospital Clínic of Barcelona, 08036 Barcelona, Spain

4. Departament of Pathology, Hospital Clínic of Barcelona, 08036 Barcelona, Spain

5. Departament of Nuclear Medicine, Hospital Clínic of Barcelona, 08036 Barcelona, Spain

6. Department of Medical Oncology, Hospital Clínic of Barcelona, 08036 Barcelona, Spain

7. Department of Radiology, Princess Alexandra Hospital, Brisbane 4102, Australia

Abstract

Background: Adjuvant radiotherapy and hormonotherapy after breast-conserving surgery (BCS) in ductal carcinoma in situ (DCIS) have been shown to reduce the risk of local recurrence. To predict the risk of ipsilateral breast tumor relapse (IBTR) after BCS, the Memorial Sloan Kettering Cancer Center (MSKCC) developed a nomogram to analyze local recurrence (LR) risk in our cohort and to assess its external validation. Methods: A historical cohort study using data from 296 patients treated for DCIS at the Hospital Clínic of Barcelona was carried out. Patients who had had a mastectomy were excluded from the analysis. Results: The mean age was 58 years (42–75), and the median follow-up time was 10.64 years. The overall local relapse rate was 13.04% (27 patients) during the study period. Actuarial 5- and 10-year IBTR rates were 5.8 and 12.9%, respectively. The external validation of the MSKCC nomogram was performed using a multivariate logistic regression analysis on a total of 207 patients, which did not reach statistical significance in the studied population for predicting LR (p = 0.10). The expression of estrogen receptors was significantly associated with a decreased risk of LR (OR: 0.25; p = 0.004). Conclusions: In our series, the LR rate was 13.4%, which was in accordance with the published series. The MSKCC nomogram did not accurately predict the IBTR in this Spanish cohort of patients treated for DCIS (p = 0.10).

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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