A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study
Background The lifespan of patients diagnosed with de novo metastatic breast cancer (dnMBC) has been prolonged. Nonetheless, there remains substantial debate regarding immediate breast reconstruction (IBR) for this particular subgroup of patients. The aim of this study was to construct a nomogram pr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/31/1/8 |
| _version_ | 1797344338104025088 |
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| author | Jingjing Zhao Shichang Bian Xu Di Chunhua Xiao |
| author_facet | Jingjing Zhao Shichang Bian Xu Di Chunhua Xiao |
| author_sort | Jingjing Zhao |
| collection | DOAJ |
| description | Background The lifespan of patients diagnosed with de novo metastatic breast cancer (dnMBC) has been prolonged. Nonetheless, there remains substantial debate regarding immediate breast reconstruction (IBR) for this particular subgroup of patients. The aim of this study was to construct a nomogram predicting the breast cancer-specific survival (BCSS) of dnMBC patients who underwent IBR. Methods A total of 682 patients initially diagnosed with metastatic breast cancer (MBC) between 2010 and 2018 in the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. All patients were randomly allocated into training and validation groups at a ratio of 7:3. Univariate Cox hazard regression, least absolute shrinkage and selection operator (LASSO), and best subset regression (BSR) were used for initial variable selection, followed by a backward stepwise multivariate Cox regression to identify prognostic factors and construct a nomogram. Following the validation of the nomogram with concordance indexes (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analyses (DCAs), risk stratifications were established. Results Age, marital status, T stage, N stage, breast subtype, bone metastasis, brain metastasis, liver metastasis, lung metastasis, radiotherapy, and chemotherapy were independent prognostic factors for BCSS. The C-indexes were 0.707 [95% confidence interval (CI), 0.666–0.748] in the training group and 0.702 (95% CI, 0.639–0.765) in the validation group. In the training group, the AUCs for BCSS were 0.857 (95% CI, 0.770–0.943), 0.747 (95% CI, 0.689–0.804), and 0.700 (95% CI, 0.643–0.757) at 1 year, 3 years, and 5 years, respectively, while in the validation group, the AUCs were 0.840 (95% CI, 0.733–0.947), 0.763 (95% CI, 0.677–0.849), and 0.709 (95% CI, 0.623–0.795) for the same time points. The calibration curves for BCSS probability prediction demonstrated excellent consistency. The DCA curves exhibited strong discrimination power and yielded substantial net benefits. Conclusions The nomogram, constructed based on prognostic risk factors, has the ability to provide personalized predictions for BCSS in dnMBC patients undergoing IBR and serve as a valuable reference for clinical decision making. |
| first_indexed | 2024-03-08T11:00:54Z |
| format | Article |
| id | doaj.art-2d3ed11542bd463fb383ec258633f23e |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-08T11:00:54Z |
| publishDate | 2023-12-01 |
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| series | Current Oncology |
| spelling | doaj.art-2d3ed11542bd463fb383ec258633f23e2024-01-26T15:57:39ZengMDPI AGCurrent Oncology1198-00521718-77292023-12-0131111513110.3390/curroncol31010008A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based StudyJingjing Zhao0Shichang Bian1Xu Di2Chunhua Xiao3Tianjin Fourth Central Hospital, The Fourth Central Hospital Affiliated to Nankai University, Tianjin 300140, ChinaTianjin Fourth Central Hospital, The Fourth Central Hospital Affiliated to Nankai University, Tianjin 300140, ChinaTianjin Fourth Central Hospital, The Fourth Central Hospital Affiliated to Nankai University, Tianjin 300140, ChinaThe First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin 300060, ChinaBackground The lifespan of patients diagnosed with de novo metastatic breast cancer (dnMBC) has been prolonged. Nonetheless, there remains substantial debate regarding immediate breast reconstruction (IBR) for this particular subgroup of patients. The aim of this study was to construct a nomogram predicting the breast cancer-specific survival (BCSS) of dnMBC patients who underwent IBR. Methods A total of 682 patients initially diagnosed with metastatic breast cancer (MBC) between 2010 and 2018 in the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. All patients were randomly allocated into training and validation groups at a ratio of 7:3. Univariate Cox hazard regression, least absolute shrinkage and selection operator (LASSO), and best subset regression (BSR) were used for initial variable selection, followed by a backward stepwise multivariate Cox regression to identify prognostic factors and construct a nomogram. Following the validation of the nomogram with concordance indexes (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analyses (DCAs), risk stratifications were established. Results Age, marital status, T stage, N stage, breast subtype, bone metastasis, brain metastasis, liver metastasis, lung metastasis, radiotherapy, and chemotherapy were independent prognostic factors for BCSS. The C-indexes were 0.707 [95% confidence interval (CI), 0.666–0.748] in the training group and 0.702 (95% CI, 0.639–0.765) in the validation group. In the training group, the AUCs for BCSS were 0.857 (95% CI, 0.770–0.943), 0.747 (95% CI, 0.689–0.804), and 0.700 (95% CI, 0.643–0.757) at 1 year, 3 years, and 5 years, respectively, while in the validation group, the AUCs were 0.840 (95% CI, 0.733–0.947), 0.763 (95% CI, 0.677–0.849), and 0.709 (95% CI, 0.623–0.795) for the same time points. The calibration curves for BCSS probability prediction demonstrated excellent consistency. The DCA curves exhibited strong discrimination power and yielded substantial net benefits. Conclusions The nomogram, constructed based on prognostic risk factors, has the ability to provide personalized predictions for BCSS in dnMBC patients undergoing IBR and serve as a valuable reference for clinical decision making.https://www.mdpi.com/1718-7729/31/1/8nomogramde novo metastatic breast cancerimmediate breast reconstructionbreast cancer-specific survivalSEER database |
| spellingShingle | Jingjing Zhao Shichang Bian Xu Di Chunhua Xiao A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study Current Oncology nomogram de novo metastatic breast cancer immediate breast reconstruction breast cancer-specific survival SEER database |
| title | A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study |
| title_full | A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study |
| title_fullStr | A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study |
| title_full_unstemmed | A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study |
| title_short | A Nomogram and Risk Classification System Predicting the Prognosis of Patients with De Novo Metastatic Breast Cancer Undergoing Immediate Breast Reconstruction: A Surveillance, Epidemiology, and End Results Population-Based Study |
| title_sort | nomogram and risk classification system predicting the prognosis of patients with de novo metastatic breast cancer undergoing immediate breast reconstruction a surveillance epidemiology and end results population based study |
| topic | nomogram de novo metastatic breast cancer immediate breast reconstruction breast cancer-specific survival SEER database |
| url | https://www.mdpi.com/1718-7729/31/1/8 |
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