A nomogram for predicting breast cancer specific survival in elderly patients with breast cancer: a SEER population-based analysis

BMC Geriatrics

Research

Xiaorong Zhong¹  Yana Qi²  Qintong Li³  Yunhao Wu⁴  Ruoning Yang⁴  Tao He⁴  Ruixian Chen⁴  Xin Zhao⁴  Weijing Liu⁴  Ya Huang⁴  Jie Chen⁵  Li Zhou⁶ 

[1] Breast Center, West China Hospital, Sichuan University, Chengdu, China;Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China;Departments of Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, Sichuan University, 610041, Chengdu, Sichuan, China;Departments of Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, 610041, Chengdu, China;Departments of Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Development and Related Diseases of Women and Children Key Laboratory of Sichuan Province, Center of Growth, Metabolism and Aging, Sichuan University, 610041, Chengdu, Sichuan, China;Departments of Obstetrics & Gynecology and Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, 610041, Chengdu, China;Division of Breast Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China;Breast Center, West China Hospital, Sichuan University, Chengdu, China;Division of Breast Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China;Breast Center, West China Hospital, Sichuan University, Chengdu, China;Department of Breast Surgery, West China Hospital, Sichuan University, Guoxue Street 37#, 610041, Chengdu, China;Public Experimental Technology Center, West China Hospital, Sichuan University, Chengdu, China;

关键词: Breast cancer;    Elderly patients;    Nomogram;    Overall survival;    Prognostic model;    Risk stratification;   

DOI  :  10.1186/s12877-023-04280-8

 received in 2022-10-07, accepted in 2023-09-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe number of elderly patients diagnosed with breast cancer is increasing worldwide. However, treatment decisions for these patients are highly variable. Although researchers have identified the effects of surgery, radiotherapy, endocrine therapy, and chemotherapy in elderly patients with breast cancer, clinicians still struggle to make appropriate decisions for these patients.MethodsWe identified 75,525 female breast cancer patients aged ≥ 70 years in the Surveillance, Epidemiology, and End Results (SEER) database treated between January 1, 2010, and December 31, 2016. The patients were further divided into training and testing cohorts. The cumulative occurrence of breast cancer-specific deaths (BCSDs) and other cause-specific deaths (OCSD) was calculated using the cumulative incidence function. In the univariate analysis, risk factors were screened using the Fine-Gray model. In the multivariate analysis for competing risks, the sub-distribution hazard ratio with a 95% confidence interval for each independent predictor associated with BCSD was calculated for the construction of nomograms. Based on the above analyses, a competing risk nomogram was constructed to predict the probability of BCSD in the 1st, 3rd, and 5th years after treatment. During validation, the concordance index (C-index) was selected to quantify the predictive ability of the competing risk model.ResultsA total of 33,118 patients were included in this study, with 24,838 in the training group and 8,280 in the testing group. Age, race, marital status, cancer grade, tumor stage, node stage, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor--2 status, and treatment including surgery, radiation, and chemotherapy were used to establish a nomogram. The C-index of 0.852 (0.842-0.862) in the training cohort and 0.876 (0.868-0.892) in the testing cohort indicated satisfactory discriminative ability of the nomogram. Calibration plots showed favorable consistency between the nomogram predictions and actual observations in both the training and validation cohorts.ConclusionsOur study identified independent predictors of BCSD in elderly patients with breast cancer. A prognostic nomogram was developed and validated to aid clinical decision-making.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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