Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer
Abstract Background Triple negative breast cancer (TNBC) is an aggressive and heterogeneous disease. Nomograms predicting outcomes of TNBC are needed for risk management. Methods Nomograms were based on an analysis of 296 non-metastatic TNBC patients treated at Sun Yat-sen Memorial Hospital from 200...
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5703-4 |
| _version_ | 1828315236793319424 |
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| author | Yaping Yang Ying Wang Heran Deng Cui Tan Qian Li Zhanghai He Wei Wei Enxiang Zhou Qiang Liu Jieqiong Liu |
| author_facet | Yaping Yang Ying Wang Heran Deng Cui Tan Qian Li Zhanghai He Wei Wei Enxiang Zhou Qiang Liu Jieqiong Liu |
| author_sort | Yaping Yang |
| collection | DOAJ |
| description | Abstract Background Triple negative breast cancer (TNBC) is an aggressive and heterogeneous disease. Nomograms predicting outcomes of TNBC are needed for risk management. Methods Nomograms were based on an analysis of 296 non-metastatic TNBC patients treated at Sun Yat-sen Memorial Hospital from 2002 to 2014. The end points were disease-free survival (DFS) and overall survival (OS). Predictive accuracy and discriminative ability were evaluated by concordance index (C-index), area under the curve (AUC) and calibration curve, and compared with the American Joint Committee on Cancer (AJCC) staging system, PREDICT and CancerMath. Models were subjected to bootstrap internal validation and external validation using independent cohorts of 191 patients from the second Xiangya Hospital and Peking University Shenzhen Hospital between 2007 and 2012. Results On multivariable analysis of training cohort, independent prognostic factors were stromal tumor-infiltrating lymphocytes (TILs), tumor size, node status, and Ki67 index, which were then selected into the nomograms. The calibration curves for probability of DFS and OS showed optimal agreement between nomogram prediction and actual observation. The C-index of nomograms was significantly higher than that of the seventh and eighth AJCC staging system for predicting DFS (training: 0.743 vs 0.666 (P = 0.003) and 0.664 (P = 0.024); validation: 0.784 vs 0.632 (P = 0.02) and 0.607 (P = 0.002)) and OS (training: 0.791 vs 0.683 (P = 0.004) and 0.677 (P < 0.001); validation: 0.783 vs 0.656 (P = 0.006) and 0.606 (P = 0.001)). Our nomograms had larger AUCs compared with PREDICT and CancerMath. In addition, the nomograms showed good performance in stratifying different risk groups of patients both in the training and validation cohorts. Conclusion We have developed novel and practical nomograms that can provide individual prediction of DFS and OS for TNBC based on stromal TILs, tumor size, node status, and Ki67 index. Our nomograms may help clinicians in risk consulting and selection of long term survivors. |
| first_indexed | 2024-04-13T16:57:15Z |
| format | Article |
| id | doaj.art-ebe4b603fe3b4783a21333ca3b8ae427 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T16:57:15Z |
| publishDate | 2019-06-01 |
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| series | BMC Cancer |
| spelling | doaj.art-ebe4b603fe3b4783a21333ca3b8ae4272022-12-22T02:38:47ZengBMCBMC Cancer1471-24072019-06-0119111210.1186/s12885-019-5703-4Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancerYaping Yang0Ying Wang1Heran Deng2Cui Tan3Qian Li4Zhanghai He5Wei Wei6Enxiang Zhou7Qiang Liu8Jieqiong Liu9Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Breast and Thyroid Surgery, Peking University Shenzhen HospitalDepartment of Breast and Thyroid Surgery, the Second Xiangya Hospital, Central South UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityAbstract Background Triple negative breast cancer (TNBC) is an aggressive and heterogeneous disease. Nomograms predicting outcomes of TNBC are needed for risk management. Methods Nomograms were based on an analysis of 296 non-metastatic TNBC patients treated at Sun Yat-sen Memorial Hospital from 2002 to 2014. The end points were disease-free survival (DFS) and overall survival (OS). Predictive accuracy and discriminative ability were evaluated by concordance index (C-index), area under the curve (AUC) and calibration curve, and compared with the American Joint Committee on Cancer (AJCC) staging system, PREDICT and CancerMath. Models were subjected to bootstrap internal validation and external validation using independent cohorts of 191 patients from the second Xiangya Hospital and Peking University Shenzhen Hospital between 2007 and 2012. Results On multivariable analysis of training cohort, independent prognostic factors were stromal tumor-infiltrating lymphocytes (TILs), tumor size, node status, and Ki67 index, which were then selected into the nomograms. The calibration curves for probability of DFS and OS showed optimal agreement between nomogram prediction and actual observation. The C-index of nomograms was significantly higher than that of the seventh and eighth AJCC staging system for predicting DFS (training: 0.743 vs 0.666 (P = 0.003) and 0.664 (P = 0.024); validation: 0.784 vs 0.632 (P = 0.02) and 0.607 (P = 0.002)) and OS (training: 0.791 vs 0.683 (P = 0.004) and 0.677 (P < 0.001); validation: 0.783 vs 0.656 (P = 0.006) and 0.606 (P = 0.001)). Our nomograms had larger AUCs compared with PREDICT and CancerMath. In addition, the nomograms showed good performance in stratifying different risk groups of patients both in the training and validation cohorts. Conclusion We have developed novel and practical nomograms that can provide individual prediction of DFS and OS for TNBC based on stromal TILs, tumor size, node status, and Ki67 index. Our nomograms may help clinicians in risk consulting and selection of long term survivors.http://link.springer.com/article/10.1186/s12885-019-5703-4NomogramsDisease-free survivalOverall survivalTriple negative breast cancerStromal tumor-infiltrating lymphocytes |
| spellingShingle | Yaping Yang Ying Wang Heran Deng Cui Tan Qian Li Zhanghai He Wei Wei Enxiang Zhou Qiang Liu Jieqiong Liu Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer BMC Cancer Nomograms Disease-free survival Overall survival Triple negative breast cancer Stromal tumor-infiltrating lymphocytes |
| title | Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer |
| title_full | Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer |
| title_fullStr | Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer |
| title_full_unstemmed | Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer |
| title_short | Development and validation of nomograms predicting survival in Chinese patients with triple negative breast cancer |
| title_sort | development and validation of nomograms predicting survival in chinese patients with triple negative breast cancer |
| topic | Nomograms Disease-free survival Overall survival Triple negative breast cancer Stromal tumor-infiltrating lymphocytes |
| url | http://link.springer.com/article/10.1186/s12885-019-5703-4 |
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