The significance of the Van Nuys Prognostic Index in the management of ductal carcinoma in situ

Gilleard, Onur; A, Goodman; Cooper, Mathew; Davis, M.A.; Dunn, Jessica

doi:10.1016/s1359-6349(08)70715-8

Cited by 19 publications

(24 citation statements)

References 4 publications

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“…In reviewing this literature I strongly recommend starting with the materials and methods to determine whether the study utilized comparable methods to define the prognostic factors. Several recent studies incorporating prognostic factors for stratification of risk have demonstrated low risk subsets to a degree comparable to the published results of the VNPI (13–18). In this issue of the Journal, Altintas et al.…”

supporting

confidence: 71%

Therapeutic Decisions for Ductal Carcinoma In Situ: A Gordian Knot

Lagios¹

2009

The Breast Journal

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supporting

confidence: 71%

Therapeutic Decisions for Ductal Carcinoma In Situ: A Gordian Knot

Lagios¹

2009

The Breast Journal

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“…Many studies have demonstrated the utility of VNPI as a prognostic tool for DCIS [24][25][26] and the VNPI has been reflected in clinical practice recommendations for the management of DCIS. Thus, metabolic parameters can be recognized as a positive predictive factor of recurrent Breast Cancer disease and may identify a DCIS and DCIS-Mi population with good prognostic features.…”

Section: Discussionmentioning

confidence: 99%

Ductal carcinoma in situ and ductal carcinoma in situ with microinvasion: correlation of FDG uptake with histological and biological prognostic factors

et al. 2016

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“…An interesting risk stratification index to assess clinical management in DCIS has been defined by Van Nuys in 1997 and updated in 2003 by adding age as a fourth independent prognostic factor (11). This index has been used successfully by us and other investigators since 1997 (33–35). This is again confirmed in the current study since a statistical association was observed between a high VNPI score and a higher risk of recurrence (p = 0.049).…”

Section: Discussionmentioning

confidence: 99%

Fine Tuning of the Van Nuys Prognostic Index (VNPI) 2003 by Integrating the Genomic Grade Index (GGI): New Tools for Ductal Carcinoma In Situ (DCIS)

et al. 2011

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Ductal carcinoma in situ (DCIS) is considered a heterogeneous premalignant condition of the breast with a certain probability for progressing to malignancy. There is no standard of care. The updated Van Nuys Prognostic Index (VNPI) 2003 is a clinical tool in treatment decision making. This study assessed the prognostic value of the VNPI after integration of proliferative biomarkers (GGI and Ki-67). DCIS samples were divided into three VNPI subgroups (low risk [score 4-6], intermediate risk [score 7-9], high risk [score 10-12]) based on nuclear grade ± necrosis, tumor size, margin width, and age. Nuclear grade was substituted by the genomic grade index (GGI) to generate the VNPI-GGI and combined with the Ki-67 to generate the VNPI-Ki67. Disease-free survival was calculated by Kaplan-Meier survival plots with log-rank significance. Multiple regression analysis was carried out using Cox proportional hazard regression analysis. A total of 88 cases (median age 54 years) with representative tissue were identified out of 168 DCIS patients. Median follow-up was more than 5 years. Ten patients developed an ipsilateral recurrence of whom nine were invasive: six patients were classified in the VNPI subgroup 2 and three patients in the VNPI subgroup 3. One non-invasive recurrence (DCIS) was classified in the VNPI subgroup III. A statistical association was observed between a high VNPI score and a higher risk of recurrence (HR = 7.72 [95% CI 1.01-58.91], p = 0.049). Ki-67 did not improve the prognostic value of VNPI (HR = 6.5, [95% CI 0.80-53.33], p = 0.08). In contrast, the VNPI-GGI could identify more accurately high-risk DCIS patients with early relapses within 5 years (HR = 18.14 [95% CI 1.75-188], p = 0.015). GGI incorporated into the VNPI improved its prognostic value for DCIS, especially for identifying early relapses. This method should be validated and incorporated in future prospective clinical DCIS trials.

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The significance of the Van Nuys Prognostic Index in the management of ductal carcinoma in situ

Cited by 19 publications

References 4 publications

Therapeutic Decisions for Ductal Carcinoma In Situ: A Gordian Knot

Therapeutic Decisions for Ductal Carcinoma In Situ: A Gordian Knot

Ductal carcinoma in situ and ductal carcinoma in situ with microinvasion: correlation of FDG uptake with histological and biological prognostic factors

Fine Tuning of the Van Nuys Prognostic Index (VNPI) 2003 by Integrating the Genomic Grade Index (GGI): New Tools for Ductal Carcinoma In Situ (DCIS)

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