Development of a comprehensive prognostic model of lymphedema risk for breast cancer survivors.

• DOI: 10.1200/jco.2019.37.15_suppl.e23083
• Publication Date: 2019-05-28T13:59:28Z
• Authors: Jennifer Kwan; Petra Famiyeh; Jie Su; Wei Xu; Kenneth Yip; Fei Fei Liu
• Keywords: Supraclavicular lymph nodes; Secondary lymphedema

e23083 Background: Lymphedema is a side-effect of cancer treatment affecting up to 1 in 5 survivors. It associated with life-threatening medical complications and higher costs. To facilitate early detection lymphedema high-risk patients, improved prognostic modeling required. Methods: The study cohort comprised female breast survivors at the Princess Margaret Cancer Centre during 2016-18. Using diagnosis as end-point, Cox proportional-hazards model was applied patient, disease, treatment-related parameters assess performance established putative novel factors for lymphedema. Concordance index (C-index) Kaplan-Meier analyses were used evaluate performance. Results: A total 176 included preliminary analysis. On univariable analysis, traditional risk (e.g. axillary lymph node dissection, number nodes dissected, use radiotherapy) significant (p < 0.05). Additionally, other radiation boost, supraclavicular radiation), disease tumor size, positive nodes, stage), patient/biological developing surgical seroma) Multivariable analysis revealed one factor (i.e. dissected) details axillary/supraclavicular radiation) be most factors. Combining C-index from 0.609 0.710 separated patients into high- low-risk groups 2-year lymphedema-free survivals 26% (15-44%) 85% (74-97%) respectively 0.001). Conclusions: Prognostication can by considering details, including boost site radiotherapy. Biological factors, such seroma, may reveal predisposition towards edema. Validation on an independent data set being completed. Prospective validation also