Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based study
BackgroundFor patients with locally advanced breast cancer (LABC), conventional TNM staging is not accurate in predicting survival outcomes. The aim of this study was to develop two accurate survival prediction models to guide clinical decision making.MethodsA retrospective analysis of 22,842 LABC p...
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Frontiers Media S.A.
2022-09-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.969030/full |
| _version_ | 1797995370555375616 |
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| author | Fangxu Yin Song Wang Chong Hou Yiyuan Zhang Zhenlin Yang Xiaohong Wang |
| author_facet | Fangxu Yin Song Wang Chong Hou Yiyuan Zhang Zhenlin Yang Xiaohong Wang |
| author_sort | Fangxu Yin |
| collection | DOAJ |
| description | BackgroundFor patients with locally advanced breast cancer (LABC), conventional TNM staging is not accurate in predicting survival outcomes. The aim of this study was to develop two accurate survival prediction models to guide clinical decision making.MethodsA retrospective analysis of 22,842 LABC patients was performed from 2010 to 2015 using the Surveillance, Epidemiology and End Results (SEER) database. An additional cohort of 200 patients from the Binzhou Medical University Hospital (BMUH) was analyzed. The least absolute shrinkage and selection operator (LASSO) regression was used to screen for variables. The identified variables were used to build a survival prediction model. The performance of the nomogram models was assessed based on the concordance index (C-index), calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA).ResultsThe LASSO analysis identified 9 variables in patients with LABC, including age, marital status, Grade, histological type, T-stage, N-stage, surgery, radiotherapy, and chemotherapy. In the training cohort, the C-index of the nomogram in predicting the overall survival (OS) was 0.767 [95% confidence intervals (95% CI): 0.751–0.775], cancer specific survival (CSS) was 0.765 (95% CI: 0.756–0.774). In the external validation cohort, the C-index of the nomogram in predicting the OS was 0.858 (95% CI: 0.812–0.904), the CSS was 0.866 (95% CI: 0.817–0.915). In the training cohort, the area under the receiver operator characteristics curve (AUC) values of the nomogram in prediction of the 1, 3, and 5-year OS were 0.836 (95% CI: 0.821–0.851), 0.769 (95% CI: 0.759–0.780), and 0.750 (95% CI: 0.738–0.762), respectively. The AUC values for prediction of the 1, 3, and 5-year CSS were 0.829 (95% CI: 0.811–0.847), 0.769 (95% CI: 0.757–0.780), and 0.745 (95% CI: 0.732–0.758), respectively. Results of the C-index, ROC curve, and DCA demonstrated that the nomogram was more accurate in predicting the OS and CSS of patients compared with conventional TNM staging.ConclusionTwo prediction models were developed and validated in this study which provided more accurate prediction of the OS and CSS in LABC patients than the TNM staging. The constructed models can be used for predicting survival outcomes and guide treatment plans for LABC patients. |
| first_indexed | 2024-04-11T10:00:27Z |
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| language | English |
| last_indexed | 2024-04-11T10:00:27Z |
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| spelling | doaj.art-58bfe757de2d482484faf73491118a142022-12-22T04:30:26ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-09-011010.3389/fpubh.2022.969030969030Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based studyFangxu Yin0Song Wang1Chong Hou2Yiyuan Zhang3Zhenlin Yang4Xiaohong Wang5Department of Thyroid and Breast Surgery, Binzhou Medical University Hospital, Binzhou, ChinaDepartment of Thyroid and Breast Surgery, Binzhou Medical University Hospital, Binzhou, ChinaDepartment of Gastroenterology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, ChinaDepartment of Reproductive Endocrinology, Affiliated Reproductive Hospital of Shandong University, Jinan, ChinaDepartment of Thyroid and Breast Surgery, Binzhou Medical University Hospital, Binzhou, ChinaDepartment of Thyroid and Breast Surgery, Binzhou Medical University Hospital, Binzhou, ChinaBackgroundFor patients with locally advanced breast cancer (LABC), conventional TNM staging is not accurate in predicting survival outcomes. The aim of this study was to develop two accurate survival prediction models to guide clinical decision making.MethodsA retrospective analysis of 22,842 LABC patients was performed from 2010 to 2015 using the Surveillance, Epidemiology and End Results (SEER) database. An additional cohort of 200 patients from the Binzhou Medical University Hospital (BMUH) was analyzed. The least absolute shrinkage and selection operator (LASSO) regression was used to screen for variables. The identified variables were used to build a survival prediction model. The performance of the nomogram models was assessed based on the concordance index (C-index), calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA).ResultsThe LASSO analysis identified 9 variables in patients with LABC, including age, marital status, Grade, histological type, T-stage, N-stage, surgery, radiotherapy, and chemotherapy. In the training cohort, the C-index of the nomogram in predicting the overall survival (OS) was 0.767 [95% confidence intervals (95% CI): 0.751–0.775], cancer specific survival (CSS) was 0.765 (95% CI: 0.756–0.774). In the external validation cohort, the C-index of the nomogram in predicting the OS was 0.858 (95% CI: 0.812–0.904), the CSS was 0.866 (95% CI: 0.817–0.915). In the training cohort, the area under the receiver operator characteristics curve (AUC) values of the nomogram in prediction of the 1, 3, and 5-year OS were 0.836 (95% CI: 0.821–0.851), 0.769 (95% CI: 0.759–0.780), and 0.750 (95% CI: 0.738–0.762), respectively. The AUC values for prediction of the 1, 3, and 5-year CSS were 0.829 (95% CI: 0.811–0.847), 0.769 (95% CI: 0.757–0.780), and 0.745 (95% CI: 0.732–0.758), respectively. Results of the C-index, ROC curve, and DCA demonstrated that the nomogram was more accurate in predicting the OS and CSS of patients compared with conventional TNM staging.ConclusionTwo prediction models were developed and validated in this study which provided more accurate prediction of the OS and CSS in LABC patients than the TNM staging. The constructed models can be used for predicting survival outcomes and guide treatment plans for LABC patients.https://www.frontiersin.org/articles/10.3389/fpubh.2022.969030/fulllocally advanced breast canceroverall survivalprognosiscancer specific survivalSEERnomogram |
| spellingShingle | Fangxu Yin Song Wang Chong Hou Yiyuan Zhang Zhenlin Yang Xiaohong Wang Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based study Frontiers in Public Health locally advanced breast cancer overall survival prognosis cancer specific survival SEER nomogram |
| title | Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based study |
| title_full | Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based study |
| title_fullStr | Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based study |
| title_full_unstemmed | Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based study |
| title_short | Development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients: A SEER population-based study |
| title_sort | development and validation of nomograms for predicting overall survival and cancer specific survival in locally advanced breast cancer patients a seer population based study |
| topic | locally advanced breast cancer overall survival prognosis cancer specific survival SEER nomogram |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.969030/full |
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