Nomograms predict survival in elderly women with triple-negative breast cancer: A SEER population-based study

Article type: Research Article

Authors: Feng, Ruigang^{a; b; c; d; e} | Huang, Wenwen^{a; b; c; d; f} | Liu, Bowen^{a; b; c; d} | Li, Dan^{a; b; c; d} | Zhao, Jinlai^{a; b; c; d; g} | Yu, Yue^{a; b; c; d} | Cao, Xuchen^{a; b; c; d} | Wang, Xin^{a; b; c; d; *}

Affiliations: [a] The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China | [b] Tianjin’s Clinical Research Center for Cancer, Tianjin, China | [c] Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China | [d] Key Laboratory of Cancer Prevention and Therapy, Tianjin, China | [e] Department of General Surgery, Second Central Hospital of Baoding, Baoding, Hebei, China | [f] Department of General Surgery, The Second Hospital of Chifeng, Chifeng, Inner Mongolia, China | [g] Department of Gastrointestinal Surgery, Central Hospital of Tangshan, Tangshan, Hebei, China

Correspondence: [*] Corresponding author: Xin Wang, The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Huan-Hu-Xi Road, He-Xi District, Tianjin 300060, China. Tel.: +86 22 23340123 ext. 2084; E-mail: [email protected].

Abstract: BACKGROUND: The effective treatment of breast cancer in elderly patients remains a major challenge. OBJECTIVE: To construct a nomogram affecting the overall survival of triple-negative breast cancer (TNBC) and establish a survival risk prediction model. METHODS: A total of 5317 TPBC patients with negative expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) who were diagnosed and received systematic treatment from 2010 to 2015 were collected from the American Cancer Surveillance, Epidemiology and End Results (SEER) database. They were randomly divided into training set (n= 3721) and validation set (n= 1596). Univariate and multivariate Cox regression analysis were used to identify prognostic features, and a nomogram was established to predict the probability of 1-year, 3-year and 5-year OS and BCSS. We used consistency index (C-index), calibration curve, area under the curve (AUC) and decision curve analysis (DCA) to evaluate the predictive performance and clinical utility of the nomogram. RESULTS: The C-indices of the nomograms for OS and BCSS in the training cohort were 0.797 and 0.825, respectively, whereas those in the validation cohort were 0.795 and 0.818, respectively. The receiver operating characteristic (ROC) curves had higher sensitivity at all specificity values as compared with the Tumor Node Metastasis (TNM) system. The calibration plot revealed a satisfactory relationship between survival rates and predicted outcomes in both the training and validation cohorts. DCA demonstrated that the nomogram had clinical utility when compared with the TNM staging system. CONCLUSION: This study provides information on population-based clinical characteristics and prognostic factors for patients with triple-negative breast cancer, and constructs a reliable and accurate prognostic nomogram.

Keywords: Triple negative breast cancer, nomogram, overall survival, breast cancer-specific survival, SEER database

DOI: 10.3233/THC-231240

Journal: Technology and Health Care, vol. 32, no. 4, pp. 2445-2461, 2024