Nomograms for prediction of overall and cancer-specific survival in young breast cancer

Sun, Yi; Li, Yuqiang; Wu, Jiarui; Tian, Huan; Liu, Huanhuan; Fang, Yingqing; Li, Yudong; Yu, Fang

doi:10.1007/s10549-020-05870-5

Cited by 18 publications

(17 citation statements)

References 55 publications

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“…insignificant prognostic factor in the multivariable analysis with Cox regression for overall survival and cancer-specific survival (19), which is obviously inconsistent with most studies without age grouping. Moreover, young individuals failed to obtain equivalent survival benefits from chemotherapy compared to over-65 patients with colorectal cancer (13).…”

Section: Discussioncontrasting

confidence: 58%

“…Numerous tumors exhibit differences in molecular background, biological behavior, etiology as well as therapeutic response among various age groups ( 9 , 14 – 18 ). A recent research study focusing on young breast cancer patients found that chemotherapy was an insignificant prognostic factor in the multivariable analysis with Cox regression for overall survival and cancer-specific survival ( 19 ), which is obviously inconsistent with most studies without age grouping. Moreover, young individuals failed to obtain equivalent survival benefits from chemotherapy compared to over-65 patients with colorectal cancer ( 13 ).…”

Section: Discussionmentioning

confidence: 88%

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The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age

Liu

Zhou

et al. 2021

Front. Oncol.

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IntroductionTotal mesorectal excision (TME), chemotherapy (CT), and radiotherapy (RT) are usually integrated into the comprehensive treatment of stage II/III rectal cancer (RC). Neoadjuvant radiotherapy (nRT) has become the standard treatment for stage II/III RC patients to help reduce the size of a tumor or kill cancer cells that have spread. Adjuvant RT is delivered after the resection to destroy remaining cancer cells and used mainly in stage II/III RC patients who have not received preoperative radiotherapy, such as those who suffered from a bowel obstruction before surgery. It is controversial whether radiotherapy can improve the survival of stage II/III RC patients. An increasing number of studies have reported that rectal cancer exhibited mismatched biology, epidemiology, and therapeutic response to current treatment strategy in different age groups. It is necessary to investigate whether radiotherapy exhibits disparate effects in different age groups of patients with stage II/III RC.MethodsData from the Surveillance, Epidemiology, and End Results (SEER) Program was extracted to identify stage II/III RC diagnosed in the periods of 2004–2016. The statistical methods included Pearson’s chi-square test, log-rank test, Cox regression model, and propensity score matching.ResultsNeoadjuvant radiotherapy (nRT) cannot improve the prognosis, and postoperative RT may even reduce the survival time for early onset stage II/III RC. Postoperative RT was not able to improve the overall survival (OS), while nRT may provide limited survival improvement for middle-aged stage II/III RC patients. In addition, radiotherapy can significantly improve the prognosis for elderly stage II/III RC.ConclusionsThis study indicated the inconsistent survival effect of radiotherapy on stage II/III rectal cancer patients in different age groups. Hence, we formulated a novel flow chart of radiotherapy decision-making based on age in stage II/III RC patients.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 88%

The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age

Liu

Zhou

et al. 2021

Front. Oncol.

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“…In 2020, through univariate and multivariate Cox analyses, Yi and colleagues developed a nomogram that included 13 predictors to predict the survival probability for YBC patients. 18 However, we considered that too many predictors are unnecessary for clinical application because the inclusion of variables that are not significantly related to the outcome contributed little to the improvement of the model. Compared with the traditional multivariable regression, LASSO regression was considered as a better method to select variables since it can minimize overfitting and reduce the complexity of the model by using a loss function or penalty term that is added to the objective function.…”

Section: Discussionmentioning

confidence: 99%

“…The prognostic role of LNR in YBC has been discussed in a previous report, but the cutoff point of LNR was based on other types of breast cancer instead of YBC. 18 In our study, LNR was analyzed as a continuous independent variable, and the analysis result was presented through the time-dependent area under the receiver operating characteristic curve (AUC) values. Furthermore, to avoid redundancy or overfitting, LASSO regression was used to screen the most significant factors related to OS for nomogram construction.…”

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confidence: 99%

Survival Nomogram for Young Breast Cancer Patients Based on the SEER Database and an External Validation Cohort

et al. 2022

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Background Young breast cancer (YBC) patients are more prone to lymph node metastasis than other age groups. Our study aimed to investigate the predictive value of lymph node ratio (LNR) in YBC patients and create a nomogram to predict overall survival (OS), thus helping clinical diagnosis and treatment. Methods Patients diagnosed with YBC between January 2010 and December 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled and randomly divided into a training set and an internal validation set with a ratio of 7:3. An independent cohort from our hospital was used for external validation. Univariate and least absolute shrinkage and selection operator (LASSO) regression were used to identify the significant factors associated with prognosis, which were used to create a nomogram for predicting 3- and 5-year OS. Results We selected seven survival predictors (tumor grade, T-stage, N-stage, LNR, ER status, PR status, HER2 status) for nomogram construction. The C-indexes in the training set, the internal validation set, and the external validation set were 0.775, 0.778 and 0.817, respectively. The nomogram model was well calibrated, and the time-dependent ROC curves verified the superiority of our model for clinical usefulness. In addition, the nomogram classification could more precisely differentiate risk subgroups and improve the discrimination of YBC prognosis. Conclusions LNR is a strong predictor of OS in YBC patients. The novel nomogram based on LNR is a reliable tool to predict survival, which may assist clinicians in identifying high-risk patients and devising individual treatments.

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“…For example, young patients and elderly patients with pancreatic cancer benefit from comprehensive treatment differently. Another study found that chemotherapy didn't seem to affect the prognosis of young patients with breast cancer, which is obviously inconsistent with most studies that are not grouped by age (20). In addition, a recent study focusing on stage II/III rectal cancer revealed that radiotherapy had different effects on the survival of patients at different ages (21).…”

Section: Discussionmentioning

confidence: 88%

The Survival Effect of Radiotherapy on Stage IIB/III Pancreatic Cancer Undergone Surgery in Different Age and Tumor Site Groups: A Propensity Scores Matching Analysis Based on SEER Database

Wang

Tian

et al. 2022

Front. Oncol.

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BackgroundIt remains controversial whether radiotherapy (RT) improves survival in patients with stage IIB/III PDAC. A growing number of studies have found that patients’ age at diagnosis and tumor site not only affect prognosis, but also may lead to different treatment responses. Therefore, the purpose of this study was to verify whether the survival effect of radiotherapy in patients with stage IIB/III PDAC varies across age and tumor site groups.MethodsThe target population was selected from PDAC patients undergone surgery in the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. This study performed the Pearson’s chi-square test, Cox regression analysis, Kaplan-Meier (K-M) method, and focused on propensity frequency matching analysis.ResultsNeither neoadjuvant radiotherapy (nRT) nor adjuvant radiotherapy (aRT) patient group had probably improved survival among early-onset patients. For middle-aged patients, nRT seemed to fail to extend overall survival (OS), while aRT might improve the OS. Plus, both nRT and aRT were associated with improved survival in elderly patients. The aRT might be related with survival benefits in patients with pancreatic head cancer, while nRT was not. And RT in patients with PDAC at other sites did not appear to provide a survival benefit.ConclusionCarefully selected data from the SEER database suggested that age and tumor location may be the reference factors to guide the selection of RT for patients with stage IIB/III PDAC. These findings are likely to contribute to the development of personalized treatment for patients with stage IIB/III PDAC.

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Nomograms for prediction of overall and cancer-specific survival in young breast cancer

Cited by 18 publications

References 55 publications

The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age

The Survival Effect of Radiotherapy on Stage II/III Rectal Cancer in Different Age Groups: Formulating Radiotherapy Decision-Making Based on Age

Survival Nomogram for Young Breast Cancer Patients Based on the SEER Database and an External Validation Cohort

The Survival Effect of Radiotherapy on Stage IIB/III Pancreatic Cancer Undergone Surgery in Different Age and Tumor Site Groups: A Propensity Scores Matching Analysis Based on SEER Database

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