A Nomogram To Predict The Recurrence Risk Of Postoperative Luminal B Breast Cancer

Objective:The aim of this study was to investigate the risk factors influencing early recurrence of postoperative Luminal B breast cancer and to construct the nomogram which can be used to predict the recurrence time and make individual prognosis prediction.Methods: Luminal B breast cancer patients which were collected were confirmed by immunohistochemical staining,they were treated in our hospital from January 2009 to December 2015.For patients who were not relapsed,their follow-up time required greater than or equal 2 years.We collected and documented patients’ clinical information including their ages,menstrual states,blood lipids levels,physical state score,Charlson comorbidity index(CCI),the level of serum CA153 before the surgery,the neutrophil-to-lymphocyte ratio;their pathological information,including ER,PR,Ki67,Her-2,lymph node stage,the size of tumors;their treatment information,including surgical methods,endocrine treatment programs,chemotherapy regimens,acceptance of radiotherapy and target therapy.Univariate and multivariate analysis were used to find the independent influencing factors of disease-free survival(DFS)of Luminal B breast cancer.Survival curves were analyzed by Kaplan–Meier method,and compared by Log rank test.Based on COX Model,a nomogram to predict the prognosis of postoperative Luminal B breast cancer was constructed by R Language.Results: 249 patients were enrolled in this study from total 416 patient who were diagnosed with Luminal B breast cancer.The median follow-up time was 38.4months(range from 7.3 to 99.43 months).The 1-year,2-year,and 3-year disease-free survival rates were 94.4%,85.1% and 80.1%,respectively.There were 54 cases of all enrolled patients relapsed after surgury,and the Cumulative recurrence rate(CRR)of1,2,3 and 5 years were 5.6%,14.9%,18.9% and 21.7% respectively.Among them68.5%(37/54)patients relapsed within 2 years(early recurrence group)and31.5%(17/54)patients relapsed 2 to 5 years later(late recurrence group).Univariate analysis and the following multivariate analysis showed that PR(HR=0.293,P=0.019),endocrine treatment programs(HR=0.443,P<0.001),lymph node stage(HR=1.551,P=0.001)were the independent prognostic factors of DFS of Luminal B breast cancer.Nomogram was constructed based on endocrine treatment programs,lymph node stage,PR and the C-Index of the nomogram was 0.756(95% CI:0.688-0.824).Conclusion:The DFS of postoperative Luminal B breast cancer was associated with PR,lymph node stage,and endocrine treatment programs.A nomogram based on the three factors above could be used to predict recurr 2,3 and 5 years DFS for postoperative Luminal B breast cancer.