Division of Frontier Medical Science, Department of Surgery, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Surg Today. 2012 Feb;42(3):245-9. doi: 10.1007/s00595-011-0088-2. Epub 2011 Dec 14.
Axillary lymph node dissection (ALND) remains the standard procedure for breast cancer patients with sentinel lymph node (SLN) metastasis; however, additional nodal metastasis is detected in completion ALND in only about 50% of these patients. To identify the risk of non-SLN metastasis, the Memorial Sloan-Kettering Cancer Center (MSKCC) developed a nomogram. Many validation studies have been performed to evaluate the accuracy of the nomogram in Western populations, but not in Asians. We conducted this study to establish the accuracy of the nomogram in a Japanese population.
The accuracy of the MSKCC nomogram for predicting non-SLN status was tested in 116 consecutive SLN-positive patients in our hospital. We then compared the findings of the source MSKCC study with those of our study. A receiver operating characteristics (ROC) curve was plotted, and the area under the curve (AUC) was calculated to assess the discriminative power.
Despite the differences between our patients and the source population in many respects, the area under the ROC curve was 0.73, which was comparable to that obtained in the study on the source population.
The MSKCC nomogram provides a fairly accurate predicted probability for the likelihood of non-SLN metastases. Accordingly, it served as a useful tool for our Japanese patients with SLN metastases.
腋窝淋巴结清扫术（ALND）仍然是前哨淋巴结（SLN）转移的乳腺癌患者的标准治疗方法；然而，在这些患者中，仅约 50%的患者在完成 ALND 时发现了非 SLN 转移。为了确定非 SLN 转移的风险，纪念斯隆-凯特琳癌症中心（MSKCC）开发了一个列线图。已经进行了许多验证研究来评估该列线图在西方人群中的准确性，但在亚洲人群中尚未进行验证。我们进行这项研究是为了确定该列线图在日本人群中的准确性。
我们在我院的 116 例连续 SLN 阳性患者中测试了 MSKCC 列线图预测非 SLN 状态的准确性。然后，我们将源 MSKCC 研究的结果与我们的研究结果进行了比较。绘制了受试者工作特征（ROC）曲线，并计算曲线下面积（AUC）以评估判别能力。
尽管我们的患者与源人群在许多方面存在差异，但 ROC 曲线下面积为 0.73，与源人群研究中的结果相当。
MSKCC 列线图为非 SLN 转移的可能性提供了相当准确的预测概率。因此，它为我们的日本 SLN 转移患者提供了一个有用的工具。
