用于预测老年三阴性浸润性导管乳腺癌患者新辅助化疗后生存情况的列线图的开发与验证：一项基于监测、流行病学和最终结果（SEER）数据库人群的研究

Development and validation of a nomogram to predict survival after neoadjuvant chemotherapy in elderly women with triple-negative invasive ductal breast cancer: A SEER population-based study.

作者信息

Gao Ying, Wang Jinmiao, Wang Shoujun, Tao Weijie, Duan Ran, Hao Jie, Gao Ming

机构信息

From the Department of Breast and Thyroid Surgery (Y. Gao, J. Wang, S. Wang, Tao, Duan, Hao, M. Gao), Tianjin Union Medical Center, from the Department of Thyroid and Neck Oncology (Y. Gao), Tianjin Medical University Cancer Hospital, National Clinical Research Center for Malignant Tumors, Tianjin Clinical Research Center for Malignant Tumors, Tianjin Key Laboratory of Cancer Prevention and Treatment, and from the Medical College (J. Wang, S. Wang), Nankai University, Tianjin, China.

出版信息

Saudi Med J. 2025 Jan;46(1):43-51. doi: 10.15537/smj.2025.46.1.20240341.

DOI:10.15537/smj.2025.46.1.20240341

PMID:39779351

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11717112/

Abstract

OBJECTIVES

To construct and verify a nomogram for post-neoadjuvant chemotherapy survival predication in elderly women with triple-negative invasive ductal breast cancer.

METHODS

Elderly patients diagnosed as triple-negative invasive ductal breast cancer between 2019-2000 were screened from surveillance, epidemiology, and end results database. Depending on the post-neoadjuvant chemotherapy pathological response, they were assigned to the complete or non-complete response group. Inter-group clinicopathological characteristics and disease-specific and overall survivals were compared. Then, they were allocated randomly into the training or validation cohort. A prediction nomogram was developed in the training cohort and verified in the validation cohort.

RESULTS

A total of 382 patients were included, with 285 patients in non-response group and 97 patients in response group. After propensity score matching, disease-specific survival showed a significant difference between response and non-response groups (88.7% versus 64.6%, <0.001). The training cohort included 196 patients and the validation cohort included 82 patients. A total of 7 variables (age, race, tumor location, tumor-node-metastasis stage, summary stage, receipt of surgery, and response to neoadjuvant chemotherapy) were integrated to construct a survival prediction nomogram. The C-indexes were 0.756 in the training cohort and 0.791 in the validation cohort. In both cohorts, the predicted survival showed satisfactory coherence with the actual survival in the calibration curve analysis.

CONCLUSION

In elderly women with triple-negative invasive ductal breast cancer, post-neoadjuvant chemotherapy pathological complete response could indicate improved disease-specific survival. A novel survival prediction nomogram was created to have satisfactory performance in these patients.

摘要

目的

构建并验证用于预测老年三阴性浸润性导管乳腺癌患者新辅助化疗后生存情况的列线图。

方法

从监测、流行病学和最终结果数据库中筛选出2000 - 2019年期间被诊断为三阴性浸润性导管乳腺癌的老年患者。根据新辅助化疗后的病理反应，将他们分为完全缓解组或非完全缓解组。比较两组间的临床病理特征、疾病特异性生存率和总生存率。然后，将他们随机分配到训练队列或验证队列中。在训练队列中开发预测列线图，并在验证队列中进行验证。

结果

共纳入382例患者，其中非缓解组285例，缓解组97例。倾向评分匹配后，缓解组和非缓解组的疾病特异性生存率存在显著差异（88.7%对64.6%，<0.001）。训练队列包括196例患者，验证队列包括82例患者。总共整合了7个变量（年龄、种族、肿瘤位置、肿瘤-淋巴结-转移分期、总结分期、手术情况以及对新辅助化疗的反应）来构建生存预测列线图。训练队列中的C指数为0.756，验证队列中的C指数为0.791。在两个队列中，校准曲线分析显示预测生存率与实际生存率具有良好的一致性。