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KMID : 1134120130160010097
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Journal of Breast Cancer
2013 Volume.16 No. 1 p.97 ~ p.103
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Validation of a Web-Based Tool to Predict the Ipsilateral Breast Tumor Recurrence (IBTR! 2.0) after Breast-Conserving Therapy for Korean Patients
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Jung Seung-Pil
Bae Jeoung-Won
Hur Sung-Mo
Lee Se-Kyung
Kim Sang-Min
Choi Min-Young
Bae Soo-Youn
Kim Ji-Young
Kim Min-Kuk
Kil Won-Ho
Choe Jun-Ho
Kim Jung-Han
Kim Jee-Soo
Nam Seok-Jin
Lee Jeong-Eon
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Abstract
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Purpose: IBTR! 2.0 is a web-based nomogram that predicts the 10-year ipsilateral breast tumor recurrence (IBTR) rate after breast-conserving therapy. We validated this nomogram in Korean patients.
Methods: The nomogram was tested for 520 Korean patients, who underwent breast-conserving surgery followed by radiation therapy. Predicted and observed 10-year outcomes were compared for the entire cohort and for each group, predefined by nomogram-predicted risks: group 1, <3%; group 2, 3% to 5%; group 3, 5% to 10%; group 4, >10%.
Results: In overall patients, the overall 10 year predicted and observed estimates of IBTR were 5.22% and 5.70% (p=0.68). In group 1, (n=124), the predicted and observed estimates were 2.25% and 1.80% (p=0.73), in group 2 (n=177), 3.95% and 3.90% (p=0.97), in group 3 (n=181), 7.14% and 8.80% (p=0.42), and in group 4 (n=38), 11.66% and 14.90% (p=0.73), respectively.
Conclusion: In a previous validation of this nomogram based on American patients, nomogram-predicted IBTR rates were overestimated in the high-risk subgroup. However, our results based on Korean patients showed that the observed IBTR was higher than the predicted estimates in groups 3 and 4. This difference may arise from ethnic differences, as well as from the methods used to detect IBTR and the healthcare environment. IBTR! 2.0 may be considered as an acceptable nomogram in Korean patients with low- to moderate-risk of in-breast recurrence. Before widespread use of this nomogram, the IBTR! 2.0 needs a larger validation study and continuous modification.
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KEYWORD
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Breast neoplasms, Nomograms, Radiotherapy, Recurrence, Validation studies
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