Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer
The Nottingham prognostic index plus (NPI+) is based on the assessment of biological class combined with established clinicopathologic prognostic variables providing improved patient outcome stratification for breast cancer superior to the traditional NPI. This study aimed to determine prognostic ca...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
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Springer Verlag
2016
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| Online Access: | https://eprints.nottingham.ac.uk/33206/ |
| _version_ | 1848794583070146560 |
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| author | Green, Andrew R. Soria, Daniele Powe, Desmond G. Nolan, Christopher C. Aleskandarany, Mohammed A. Szász, M.A. Tőkés, A.M. Ball, G.R. Garibaldi, Jonathan M. Rakha, Emad Kulka, J. Ellis, Ian O. |
| author_facet | Green, Andrew R. Soria, Daniele Powe, Desmond G. Nolan, Christopher C. Aleskandarany, Mohammed A. Szász, M.A. Tőkés, A.M. Ball, G.R. Garibaldi, Jonathan M. Rakha, Emad Kulka, J. Ellis, Ian O. |
| author_sort | Green, Andrew R. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | The Nottingham prognostic index plus (NPI+) is based on the assessment of biological class combined with established clinicopathologic prognostic variables providing improved patient outcome stratification for breast cancer superior to the traditional NPI. This study aimed to determine prognostic capability of the NPI+ in predicting risk of development of distant disease. A well-characterised series of 1073 primary early-stage BC cases treated in Nottingham and 251 cases from Budapest were immunohistochemically assessed for cytokeratin (Ck)5/6, Ck18, EGFR, oestrogen receptor (ER), progesterone receptor, HER2, HER3, HER4, Mucin 1 and p53 expression. NPI+ biological class and prognostic scores were assigned using individual algorithms for each biological class incorporating clinicopathologic parameters and investigated in terms of prediction of distant metastases-free survival (MFS). The NPI+ identified distinct prognostic groups (PG) within each molecular class which were predictive of MFS providing improved patient outcome stratification superior to the traditional NPI. NPI+ PGs, between series, were comparable in predicting patient outcome between series in luminal A, basal p53 altered and HER2+/ER+ (p > 0.01) tumours. The low-risk groups were similarly validated in luminal B, luminal N, basal p53 normal tumours (p > 0.01). Due to small patient numbers the remaining PGs could not be validated. NPI+ was additionally able to predict a higher risk of metastases at certain distant sites. This study may indicate the NPI+ as a useful tool in predicting the risk of metastases. The NPI+ provides accurate risk stratification allowing improved individualised clinical decision making for breast cancer. |
| first_indexed | 2025-11-14T19:18:30Z |
| format | Article |
| id | nottingham-33206 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:18:30Z |
| publishDate | 2016 |
| publisher | Springer Verlag |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-332062020-05-04T17:43:31Z https://eprints.nottingham.ac.uk/33206/ Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer Green, Andrew R. Soria, Daniele Powe, Desmond G. Nolan, Christopher C. Aleskandarany, Mohammed A. Szász, M.A. Tőkés, A.M. Ball, G.R. Garibaldi, Jonathan M. Rakha, Emad Kulka, J. Ellis, Ian O. The Nottingham prognostic index plus (NPI+) is based on the assessment of biological class combined with established clinicopathologic prognostic variables providing improved patient outcome stratification for breast cancer superior to the traditional NPI. This study aimed to determine prognostic capability of the NPI+ in predicting risk of development of distant disease. A well-characterised series of 1073 primary early-stage BC cases treated in Nottingham and 251 cases from Budapest were immunohistochemically assessed for cytokeratin (Ck)5/6, Ck18, EGFR, oestrogen receptor (ER), progesterone receptor, HER2, HER3, HER4, Mucin 1 and p53 expression. NPI+ biological class and prognostic scores were assigned using individual algorithms for each biological class incorporating clinicopathologic parameters and investigated in terms of prediction of distant metastases-free survival (MFS). The NPI+ identified distinct prognostic groups (PG) within each molecular class which were predictive of MFS providing improved patient outcome stratification superior to the traditional NPI. NPI+ PGs, between series, were comparable in predicting patient outcome between series in luminal A, basal p53 altered and HER2+/ER+ (p > 0.01) tumours. The low-risk groups were similarly validated in luminal B, luminal N, basal p53 normal tumours (p > 0.01). Due to small patient numbers the remaining PGs could not be validated. NPI+ was additionally able to predict a higher risk of metastases at certain distant sites. This study may indicate the NPI+ as a useful tool in predicting the risk of metastases. The NPI+ provides accurate risk stratification allowing improved individualised clinical decision making for breast cancer. Springer Verlag 2016-05-01 Article PeerReviewed Green, Andrew R., Soria, Daniele, Powe, Desmond G., Nolan, Christopher C., Aleskandarany, Mohammed A., Szász, M.A., Tőkés, A.M., Ball, G.R., Garibaldi, Jonathan M., Rakha, Emad, Kulka, J. and Ellis, Ian O. (2016) Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer. Breast Cancer Research and Treatment, 157 (1). pp. 65-75. ISSN 0167-6806 Breast cancer; classification; prognostic index; molecular; clinical; outcome http://dx.doi.org/10.1007/s10549-016-3804-1 doi:10.1007/s10549-016-3804-1 doi:10.1007/s10549-016-3804-1 |
| spellingShingle | Breast cancer; classification; prognostic index; molecular; clinical; outcome Green, Andrew R. Soria, Daniele Powe, Desmond G. Nolan, Christopher C. Aleskandarany, Mohammed A. Szász, M.A. Tőkés, A.M. Ball, G.R. Garibaldi, Jonathan M. Rakha, Emad Kulka, J. Ellis, Ian O. Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer |
| title | Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer |
| title_full | Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer |
| title_fullStr | Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer |
| title_full_unstemmed | Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer |
| title_short | Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer |
| title_sort | nottingham prognostic index plus (npi+) predicts risk of distant metastases in primary breast cancer |
| topic | Breast cancer; classification; prognostic index; molecular; clinical; outcome |
| url | https://eprints.nottingham.ac.uk/33206/ https://eprints.nottingham.ac.uk/33206/ https://eprints.nottingham.ac.uk/33206/ |