The Role of the Nottingham Prognostic Index in Determining Survival Outcomes of Triple Negative Breast Cancer Patients at Prof. Dr. I.G.N.G. Ngoerah Hospital
Ni Made Tuban Ening Widiana1*, I Made Mahayasa2, Ida Bagus Made Suryawisesa3
Abstract
Background: Triple Negative Breast Cancer (TNBC) is a subtype of breast cancer that does not express the hormones Estrogen receptor (ER), Progesterone receptor (PR), and Human Epidermal growth factor Receptor 2 (HER2). In cases of breast cancer, approximately 15-20% of patients are classified as the TNBC subtype. The Nottingham Prognostic Index has been widely used and validated in various countries to indicate a poor prognosis in TNBC patients. Still, there has been no research on using this NPI score as a validation standard to increase breast cancer survival rates in Indonesia. This study aimed to determine the role of the Nottingham Prognostic Index in determining the survival of breast cancer patients, especially in Triple Negative Breast Cancer at Prof. dr. IGNG Ngoerah Hospital. Methods: This research is an observational study with a cross-sectional design, taking data from the Bali Cancer Registry. Data analysis was performed using SPSS and Stata programs. The inclusion criteria were complete data such as age, menstrual status, parity, use of hormonal contraception, tumor size, lymph nodes, and histopathological grading. Results: The results of the study showed that an NPI cut-off of ≥5.2 had a 5-year overall survival of 18.18%, while <5.2 had a survival of 94%. The Nottingham Prognostic Index plays a role in determining the survival of Triple Negative Breast Cancer patients at RSUP Prof. Dr. I.G.N.G Ngoerah, with a cut-off value of ≥5.2, obtained a kappa accuracy of 0.868, which means it is very good in determining 5-year overall survival. Tumor size > 3 cm was found to have a 5-year overall survival of 37.37% with a risk of death of 5.86 (95% CI 2.85-12.05; p<0.001). Lymph nodes with positive nodes were found to have a 5-year overall survival of 27.27% with a risk of death of 7.5 times (95% CI 2.16-25.94; p<0.001). Stage III-IV was found to have a 5-year overall survival of 47% with a risk of death of 2.45 times (CI 1.32-4.55; p=0.001). A high histopathological grade was found to have a 5-year overall survival of 49.50% with a risk of death of 2.99 times (95% CI 1.52-5.88; p=0.001). Conclusions: This study concludes that the Nottingham Prognostic Index can determine the survival of breast cancer patients, especially in Triple Negative Breast Cancer at Prof. Hospital Dr. IGNG Ngoerah.
Keywords
Nottingham Prognostic Index; breast cancer; TNBC; overall survival; prognosis.
Cite This Article
Widiana, N. M. T. E., Mahayasa, I. M., Suryawisesa, I. B. M. (2025). The Role of the Nottingham Prognostic Index in Determining Survival Outcomes of Triple Negative Breast Cancer Patients at Prof. Dr. I.G.N.G. Ngoerah Hospital. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 1: Jan-Feb 2025, Pages 99-108, URL: https://www.ijscia.com/wp-content/uploads/2025/01/Volume6-Issue1-Jan-Feb-No.828-99-108.pdf
Volume 6 | Issue 1: Jan – Feb 2025
