A Risk Stratification Model for Predicting Overall Survival and Surgical Benefit in Triple-Negative Breast Cancer Patients With de novo Distant Metastasis

Wang, Zheng; Wang, Hui; Sun, Xi; Fang, Yan; Lu, Shuang; Ding, Shu Ning; Chen, Xiao Song; Shen, Kun Wei

doi:10.3389/fonc.2020.00014

Cited by 19 publications

(18 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, patients with bone metastatic TNBC in our cohort exhibited improved survival after primary surgery. Previous study in well-selected and risk-stratified patients demonstrated similar results in TNBC tumors ( 43 ). In summary, MBC is no more a contradiction to primary surgery, specified risk-subdivision should be employed to better screen appropriate patients for customized therapy to bring along maximum benefit.…”

Section: Discussionsupporting

confidence: 69%

Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study

Liu

Lin

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

BackgroundMetastatic breast cancer (MBC) is a highly heterogeneous disease and bone is one of the most common metastatic sites. This retrospective study was conducted to investigate the clinical features, prognostic factors and benefits of surgery of breast cancer patients with initial bone metastases.MethodsFrom 2010 to 2015, 6,860 breast cancer patients diagnosed with initial bone metastasis were analyzed from Surveillance, Epidemiology, and End Results (SEER) database. Univariate and Multivariable analysis were used to identify prognostic factors. A nomogram was performed based on the factors selected from cox regression result. Survival curves were plotted according to different subtypes, metastatic burdens and risk groups differentiated by nomogram.ResultsHormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) positive patients showed the best outcome compared to other subtypes. Patients of younger age (<60 years old), white race, lower grade, lower T stage (<=T2), not combining visceral metastasis tended to have better outcome. About 37% (2,249) patients received surgery of primary tumor. Patients of all subtypes could benefit from surgery. Patients of bone-only metastases (BOM), bone and liver metastases, bone and lung metastases also showed superior survival time if surgery was performed. However, patients of bone and brain metastasis could not benefit from surgery (p = 0.05). The C-index of nomogram was 0.66. Cutoff values of nomogram point were identified as 87 and 157 points, which divided all patients into low-, intermediate- and high-risk groups. Patients of all groups showed better overall survival when receiving surgery.ConclusionOur study has provided population-based prognostic analysis in patients with initial bone metastatic breast cancer and constructed a predicting nomogram with good accuracy. The finding of potential benefit of surgery to overall survival will cast some lights on the treatment tactics of this group of patients.

show abstract

Section: Discussionsupporting

confidence: 69%

Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study

Liu

Lin

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Pathological grade, T stage, N stage, and tumor size are common risk factors in patients with TNBC and their large values indicate a high risk ( 18 , 19 , 21 ). From our nomogram, it was seen that these four factors in elderly patients with TNBC have similar conclusions with those of patients with TNBC overall.…”

Section: Discussionmentioning

confidence: 99%

Risk Stratification Model for Predicting the Overall Survival of Elderly Triple-Negative Breast Cancer Patients: A Population-Based Study

et al. 2021

View full text Add to dashboard Cite

Background: The objective of this study was to evaluate the prognostic value of clinical characteristics in elderly patients with triple-negative breast cancer (TNBC).Methods: The cohort was selected from the Surveillance, Epidemiology, and End Results (SEER) program dating from 2010 to 2015. Univariate and multivariate analyses were performed using a Cox proportional risk regression model, and a nomogram was constructed to predict the 1-, 3-, and 5-year prognoses of elderly patients with TNBC. A concordance index (C-index), calibration curve, and decision curve analysis (DCA) were used to verify the nomogram.Results: The results of the study identified a total of 5,677 patients who were randomly divided 6:4 into a training set (n = 3,422) and a validation set (n = 2,255). The multivariate analysis showed that age, race, grade, TN stage, chemotherapy status, radiotherapy status, and tumor size at diagnosis were independent factors affecting the prognosis of elderly patients with TNBC. Together, the 1 -, 3 -, and 5-year nomograms were made up of 8 variables. For the verification of these results, the C-index of the training set and validation set were 0.757 (95% CI 0.743–0.772) and 0.750 (95% CI 0.742–0.768), respectively. The calibration curve also showed that the actual observation of overall survival (OS) was in good agreement with the prediction of the nomograms. Additionally, the DCA showed that the nomogram had good clinical application value. According to the score of each patient, the risk stratification system of elderly patients with TNBC was further established by perfectly dividing these patients into three groups, namely, low risk, medium risk, and high risk, in all queues. In addition, the results showed that radiotherapy could improve prognosis in the low-risk group (P = 0.00056), but had no significant effect in the medium-risk (P < 0.4) and high-risk groups (P < 0.71). An online web app was built based on the proposed nomogram for convenient clinical use.Conclusion: This study was the first to construct a nomogram and risk stratification system for elderly patients with TNBC. The well-established nomogram and the important findings from our study could guide follow-up management strategies for elderly patients with TNBC and help clinicians improve individual treatment.

show abstract

“…In recent years, nomograms have been shown to be a viable statistical predictive model for assessing clinical outcomes and have been developed for numerous types of cancer (11)(12)(13)(14)(15)(16). Nomograms can achieve improved accuracy in the prediction of prognostic outcomes compared to many traditional staging systems (11)(12)(13)16). To the best of our knowledge, the survival of patients with POSRCC has yet to be systematically studied.…”

Section: Introductionmentioning

confidence: 99%

A prognostic nomogram for women with primary ovarian signet-ring cell carcinoma

Wang¹,

2021

Ann Transl Med

View full text Add to dashboard Cite

Background: Primary ovarian signet-ring cell carcinoma (POSRCC) is a rare subtype of ovarian carcinoma that is characterized by abundant mucin accumulation. POSRCC is aggressive, and the prognostic factors associated with its clinical outcome remain poorly defined. This study aimed to elucidate the clinical characteristics and survival of patients with POSRCC, and to establish an effective prognostic nomogram and risk stratification model to predict the risks associated with patient outcomes.Methods: Data of patients with POSRCC from the period 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Univariable and multivariable analyses of demographic factors, clinicopathological characteristics, and treatments were conducted to identify significant prognostic parameters. The identified independent variables were integrated to develop a nomogram and risk stratification model. The discrimination and calibration of the nomogram were assessed with the concordance index (C-index), receiver operating characteristic (ROC) curves, and calibration curves.Results: A total of 172 patients were identified as being eligible to participate in this study. The median overall survival (OS) time was 7 months [95% confidence interval (CI), 4.6-9.4 months]. The 1-, 3-, and 5-year OS rates were 35.5%, 15.3%, and 6%, respectively. A multivariable analysis of the primary patients identified the independent predictors for survival as age at diagnosis, race, marital status, T (primary tumor size) stage, and chemotherapy, which were all incorporated into the nomogram. The C-index was 0.70 (95% CI, 0.66-0.75), which was statistically higher than that of the International Federation of Gynecology and Obstetrics (FIGO) staging system (0.58; 95% CI, 0.53-0.63). ROC curve analysis also showed that the nomogram had good discrimination, with an area under the curve (AUC) of 0.74, 0.62, and 0.71 for 1-, 3-, and 5-year survival, respectively. The calibration curves showed good agreement between the prediction by the nomogram and actual observations. A risk stratification model was further used to classify patients into a low-risk or high-risk group. The median OS time for the low-and high-risk groups was 13.0 months (95% CI, 9.33-16.67) and 2.0 months (95% CI, 1.12-2.89), respectively. Surgery did not significantly prolong survival in either group [low-risk group: hazard ratio (HR), 0.69; 95% CI, 0.45-1.07; P=0.09; high-risk group: HR, 0.55; 95% CI, 0.46-0.67; P=0.18]. Conclusions:The proposed nomogram and risk stratification model showed accurate prognostic prediction for POSRCC. These methods could improve individualized evaluations of survival and therapeutic decisions for patients with POSRCC.

show abstract

A Risk Stratification Model for Predicting Overall Survival and Surgical Benefit in Triple-Negative Breast Cancer Patients With de novo Distant Metastasis

Cited by 19 publications

References 33 publications

Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study

Breast Subtypes and Prognosis of Breast Cancer Patients With Initial Bone Metastasis: A Population-Based Study

Risk Stratification Model for Predicting the Overall Survival of Elderly Triple-Negative Breast Cancer Patients: A Population-Based Study

A prognostic nomogram for women with primary ovarian signet-ring cell carcinoma

Contact Info

Product

Resources

About