Breast Tumor Center and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Breast Tumor Center and Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Clin Breast Cancer. 2020 Dec;20(6):e778-e785. doi: 10.1016/j.clbc.2020.06.002. Epub 2020 Jun 7.
Patients with breast cancer with pathologic N3 (pN3) lymph node status have been proven to have a poor prognosis. This study aimed to establish a nomogram to predict overall survival (OS) in patients with pN3 breast cancer.
The eligible patients from the Surveillance, Epidemiology, and End Results (SEER) database were randomly divided into training and validation cohorts. χ tests and survival curves were performed to define the consistency between these 2 cohorts. Univariate and multivariate logistic regressions were carried out to identify the independent clinicopathologic factors of patients with pN3 breast cancer. A nomogram was developed and validated internally and externally by a calibration curve and compared with the seventh edition American Joint Committee on Cancer TNM staging classification in discrimination ability.
Race, age at diagnosis, marital status, grade, T stage, N stage, breast cancer subtype, surgery, radiotherapy, and chemotherapy were independent predictive factors of OS in pN3 breast cancer. We developed a nomogram to predict 1-, 3-, and 5-year OS and further validated it in both cohorts, demonstrating better prediction capacity in OS than that of the seventh edition American Joint Committee on Cancer TNM staging classification (area under the curve in the receiver operating characteristic curve, 0.745 and 0.611 in the training cohort and 0.768 and 0.624 in the validation cohort, respectively).
We have developed and validated the first nomogram for predicting the survival of pN3 breast cancer. This nomogram accurately and reliably predicted the OS of patients with pN3 breast cancer. However, more prognostic factors need to be further explored to improve the nomogram.
病理 N3（pN3）淋巴结状态的乳腺癌患者已被证明预后不良。本研究旨在建立一个列线图来预测 pN3 乳腺癌患者的总生存期（OS）。
从监测、流行病学和最终结果（SEER）数据库中选择符合条件的患者，随机分为训练队列和验证队列。χ检验和生存曲线用于定义这两个队列之间的一致性。进行单因素和多因素逻辑回归分析，以确定 pN3 乳腺癌患者的独立临床病理因素。通过校准曲线对内外部进行验证，并与第七版美国癌症联合委员会 TNM 分期分类的区分能力进行比较。
种族、诊断时年龄、婚姻状况、分级、T 分期、N 分期、乳腺癌亚型、手术、放疗和化疗是 pN3 乳腺癌 OS 的独立预测因素。我们开发了一个列线图来预测 1 年、3 年和 5 年的 OS，并在两个队列中进行了进一步验证，结果表明该列线图在 OS 预测方面优于第七版美国癌症联合委员会 TNM 分期分类（训练队列中曲线下面积为 0.745 和 0.611，验证队列中为 0.768 和 0.624）。
我们已经开发并验证了第一个预测 pN3 乳腺癌生存的列线图。该列线图能够准确可靠地预测 pN3 乳腺癌患者的 OS。然而，需要进一步探索更多的预后因素来改进该列线图。
