Invasive micropapillary carcinoma (IMPC) is one of the rare subtypes of breast cancer. A total of 1855 IMPC patients diagnosed after surgery between 2004 and 2014 were identi ed from the Surveillance, Epidemiology and End Results (SEER) database to build a nomogram. Cox regression analysis indicated that age ≥ 62 at diagnosis, negative ER status, and tumor stage were considered adverse independent factors for overall survival (OS), while patients who were married, white or of other races, received chemotherapy or radiotherapy, had a better postoperative prognosis. The nomogram accurately predicted OS with high internal and external validation consistency index (C index) (0.756 and 0.742, respectively). The areas under the receiver operating characteristic (ROC) curves (AUCs) of the training group were 0.787, 0.774 and 0.764 for 3 years, 5 years and 10 years, respectively, while those of the validation group were 0.756, 0.766 and 0.762, respectively. The results of both decision curve analyses (DCA) and calibration curves demonstrated the good performance of the model. This study constructed a novel nomogram for IMPC of the breast patients after surgery, which has good accuracy and consistency in predicting prognosis and has clinical application value.
ObjectiveThe study aimed to analyze the prognostic factors of patients with triple-negative (TN) metaplastic breast carcinoma (MpBC) after surgery and to construct a nomogram for forecasting the 3-, 5-, and 8-year overall survival (OS).MethodsA total of 998 patients extracted from the Surveillance, Epidemiology, and End Results (SEER) database were assigned to either the training or validation group at random in a ratio of 7:3. The clinical characteristics of patients in the training and validation sets were compared, and multivariate Cox regression analysis was used to identify the independent risk variables for the OS of patients with TN MpBC after surgery. These selected parameters were estimated through the Kaplan–Meier (KM) curves using the log-rank test. The nomogram for predicting the OS was constructed and validated by performing the concordance index (C-index), receiver operating characteristics (ROC) curves with area under the receiver operating characteristic curves (AUC), calibration curves, and decision curve analyses (DCAs). Patients were then stratified as high-risk and low-risk, and KM curves were performed.ResultsMultivariate Cox regression analysis indicated that factors including age, marital status, clinical stage at diagnosis, chemotherapy, and regional node status were independent predictors of prognosis in patients with MpBC after surgery. Separate KM curves for the screened variables revealed the same statistical results as with Cox regression analysis. A prediction model was created and virtualized via nomogram based on these findings. For the training and validation cohorts, the C-index of the nomogram was 0.730 and 0.719, respectively. The AUC values of the 3-, 5-, and 8-year OS were 0.758, 0.757, and 0.785 in the training group, and 0.736, 0.735, and 0.736 for 3, 5, and 8 years in the validation group, respectively. The difference in the OS between the real observation and the forecast was quite constant according to the calibration curves. The generated clinical applicability of the nomogram was further demonstrated by the DCA analysis. In all the training and validation sets, the KM curves for the different risk subgroups revealed substantial differences in survival probabilities (P <0.001).ConclusionThe study showed a nomogram that was built from a parametric survival model based on the SEER database, which can be used to make an accurate prediction of the prognosis of patients with TN MpBC after surgery.
Invasive micropapillary carcinoma (IMPC) is one of the rare subtypes of breast cancer. A total of 1855 IMPC patients diagnosed after surgery between 2004 and 2014 were identified from the Surveillance, Epidemiology and End Results (SEER) database to build a nomogram. Cox regression analysis indicated that age ≥ 62 at diagnosis, negative ER status, and tumor stage were considered adverse independent factors for overall survival (OS), while patients who were married, white or of other races, received chemotherapy or radiotherapy, had a better postoperative prognosis. The nomogram accurately predicted OS with high internal and external validation consistency index (C index) (0.756 and 0.742, respectively). The areas under the receiver operating characteristic (ROC) curves (AUCs) of the training group were 0.787, 0.774 and 0.764 for 3 years, 5 years and 10 years, respectively, while those of the validation group were 0.756, 0.766 and 0.762, respectively. The results of both decision curve analyses (DCA) and calibration curves demonstrated the good performance of the model. This study constructed a novel nomogram for IMPC of the breast patients after surgery, which has good accuracy and consistency in predicting prognosis and has clinical application value.
Background: Invasive micropapillary carcinoma (IMPC) is one of the rare subtypes of breast cancer. This study aimed to explore a novel predictive nomogram model for IMPC prognosis.Methods: A total of 1855 IMPC patients diagnosed after surgery between 2004 and 2014 were identified from the Surveillance, Epidemiology and End Results (SEER) database to build and validate nomograms. All the patients included were divided into a training group (n=1300) and a validation group (n=555). A nomogram was created based on univariate and multivariate Cox proportional hazards regression analysis. In addition, receiver operating characteristic (ROC) curves were used to demonstrate the accuracy of the prognostic model. Decision curve analysis (DCA) was performed to evaluate the safety of the model in the range of clinical applications, while calibration curves were used to validate the prediction consistency.Results: Cox regression analysis indicated that age ≥62 at diagnosis, negative ER status, and tumor stage were considered adverse independent factors for overall survival (OS), while patients who were married, white or of other races, received chemotherapy or radiotherapy, had a better postoperative prognosis. The nomogram accurately predicted OS with high internal and external validation consistency index (C index) (0.756 and 0.742, respectively). The areas under the ROC curve (AUCs) of the training group were 0.787, 0.774 and 0.764 for 3 years, 5 years and 10 years, respectively, while those of the validation group were 0.756, 0.766 and 0.762, respectively. The results of both DCA and calibration curves demonstrated the good performance of the model.Conclusion: A novel nomogram for IMPC of the breast patients after surgery was developed to estimate 3- and 5-OS based on independent risk factors. This model has good accuracy and consistency in predicting prognosis and has clinical application value.
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