Long-term Follow-up Results of Our Patients Diagnosed with Ductal Carcinoma In Situ: Usefulness of the Van Nuys Prognostic Index

Abstract

Objective: The aim of the study was to investigate the relationship between the Van Nuys prognostic index (VNPI) score and disease-free survival (DFS) as well as overall survival (OS) in patients with ductal carcinoma in situ (DCIS). Material and Methods: Ninety-five female patients diagnosed with pure DCIS, who were treated and followed up at Kartal Dr. Lütfi Kırdar City Hospital between January 2008 and December 2018, were evaluated retrospectively. Data regarding age, DCIS diameter, grade, presence of necrosis, and surgical margin -factors used to calculate the VNPI score- were extracted from patient records. DFS was defined as the time from diagnosis to the development of ipsilateral or contralateral DCIS or invasive breast cancer. OS was defined as the time from primary DCIS diagnosis to death or the last contact. Results: A statistically significant correlation was found between the VNPI score and OS and DFS in both univariate and multivariate analyses [for OS hazard ratio (HR): 7.05, 95% confidence interval (CI): 2.57-19.35, p<0.001; for DFS HR: 8.8, 95% CI: 3.62-21.76, p<0.001]. The addition of radiotherapy to local excision showed limited benefits in the patient group with low VNPI scores. As the VNPI score increased, the contribution of radiotherapy to DFS improved. Conclusion: VNPI score can be a helpful guide in determining treatment decisions for pure DCIS.

Keywords

• ductal carcinoma in situ
• van nuys prognostic index
• disease free survival
• overall survival
• radiotherapy