Novel prognostic nomograms for female patients with breast cancer and bone metastasis at presentation
Novel prognostic nomograms for female patients with breast cancer and bone metastasis at presentation
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DOI：
10.21037/atm.2020.01.37
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发表时间：
2020-03-01
影响因子：
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通讯作者：
Ye, Zhaoming
中科院分区：
文献类型：
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作者：
Wang, Zhan;Cheng, Yonggang;Ye, Zhaoming
背景：关于乳腺癌（BC）和骨转移患者的预后评估的文献很少。迄今为止，对于如何准确预测BC患者骨转移的预后知之甚少。因此，迫切需要一种准确的预测该人群预后的工具。我们的目标是为出现骨转移的BC患者构建新的预后图。方法：我们检索了2010年至2016年间出现骨转移的BC患者的监测、流行病学和最终结果（SEER）数据库。进行多变量分析以获得显著自变量。然后，在这些独立预测因子的基础上构建新的预测图。结果：肿瘤分级、组织学类型、原发肿瘤大小、肿瘤亚型、手术、化疗和除骨外转移器官数量被认为是总生存期（OS）和肿瘤特异性生存期（CSS）的显著独立变量。然后整合这些显著变量，构建3年和5年生存率的nomogram。训练集和验证集3年和5年生存率的校准图显示，预测曲线接近45度斜线。训练组和验证组的OS c指数分别为0.705和0.678。CSS在训练和验证队列中也观察到类似的结果。结论：我们提出的影像学图能有效准确地预测BC骨转移患者的预后，为转移灶的个体化治疗提供依据。
Background: There is a paucity of literature about prognostic evaluation for patients with breast cancer (BC) and bone metastasis at presentation. To date, little is known about how to accurately predict the prognosis of BC patients with bone metastasis at presentation. Thus, an accurate prediction tool of prognosis in this population is urgently needed. Our goal is to construct novel and prognostic nomograms for BC patients with bone metastasis at presentation.Methods: We searched Surveillance, Epidemiology, and End Results (SEER) database for BC patients with bone metastasis at presentation between 2010 and 2016. Multivariate analysis was performed to obtain significantly independent variables. Then, novel prognostic nomograms were constructed based on those independent predictors.Results: Tumor grade, histological type, primary tumor size, tumor subtype, surgery, chemotherapy and number of metastatic organs except bone were recognized as significantly independent variables of both overall survival (OS) and cancer-specific survival (CSS). Then those significant variables were integrated to construct nomograms for 3- and 5-year survival. Calibration plots for the 3- and 5-year survival in training and validation sets showed that the prediction curve was close to a 45 degree slash. The C-indices of OS in training and validation cohorts were 0.705 and 0.678, respectively. Similar results were observed for CSS in training and validation cohorts.Conclusions: Our proposed nomograms can effectively and accurately predict the prognosis of BC patients with bone metastasis at presentation, which provide a basis for individual treatments for metastatic lesions.