Department of oncology, the First People's Hospital of Yinchuan, Yinchuan, China.
J BUON. 2021 Jul-Aug;26(4):1386-1397.
PURPOSE: To establish and validate nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of metaplastic breast cancer(MBC) patients. METHODS: We retrospectively enrolled 948 patients with MBC from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2016.Univariate and multivariate Cox analyses were used to determine independent prognostic factors to be included in nomograms for predicting the probabilities of OS and CSS at 1, 2, and 3 years. The concordance index (C-index), receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis were used to check the effectiveness and clinical application of the models. RESULTS: In total, 948 patients were enrolled and randomly assigned to the training (n=664) and validation (n=284) cohorts. Age, tumor size, ethnicity, AJCC stage, radiotherapy, and surgery were identified as independent prognostic factors for OS, while age, tumor size, and AJCC stage were identified as independent prognostic factors for CSS (all p <0.05) and further incorporated into the nomograms. The C-indices for OS and CSS predictions were 0.790 and 0.792 for internal validation and 0.772 and 0.768 for external validation. Both the internal and external validation calibration plots showed excellent agreement between the nomogram predictions and actual survival. ROC curves demonstrated good discriminative ability of the nomograms. CONCLUSION: Nomograms were developed to predict OS and CSS in patients with MBC. These nomograms can help clinicians make more accurate survival assessments and identify patients at high risk of death.
目的:建立和验证列线图,以预测多形性乳腺癌(MBC)患者的总生存(OS)和癌症特异性生存(CSS)。
方法:我们回顾性地纳入了 2010 年至 2016 年期间来自监测、流行病学和最终结果(SEER)数据库的 948 例 MBC 患者。单因素和多因素 Cox 分析用于确定独立的预后因素,以纳入预测 OS 和 CSS 在 1、2 和 3 年概率的列线图。一致性指数(C 指数)、接收者操作特征(ROC)曲线、校准曲线和决策曲线分析用于检查模型的有效性和临床应用。
结果:总共纳入了 948 例患者,并随机分配到训练(n=664)和验证(n=284)队列。年龄、肿瘤大小、种族、AJCC 分期、放疗和手术被确定为 OS 的独立预后因素,而年龄、肿瘤大小和 AJCC 分期被确定为 CSS 的独立预后因素(均 p<0.05),并进一步纳入列线图。OS 和 CSS 预测的 C 指数在内部验证中分别为 0.790 和 0.792,在外部验证中分别为 0.772 和 0.768。内部和外部验证的校准图均显示列线图预测与实际生存之间具有良好的一致性。ROC 曲线表明列线图具有良好的区分能力。
结论:建立了列线图来预测 MBC 患者的 OS 和 CSS。这些列线图可以帮助临床医生更准确地评估生存情况,并识别出死亡风险较高的患者。
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