Construction of a prognostic nomogram model for newly diagnosed patients with breast cancer liver metastases
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1.Department of Surgical Oncology, Shaanxi People's Hospital, Xi'an 710068, China;2.Graduate Office of Xi'an Medical University, Xi'an 710021, China;3.Department of Breast Disease, Shaanxi Cancer Hospital, Xi'an 710061, China

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R737.9

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    Abstract:

    Background and Aims The prognosis of patients with breast cancer liver metastasis (BCLM) is poor, and the prognosis is often different due to different factors. There are few studies on the prognosis of BCLM, and still a lack of accurate prediction method for the prognosis of BCLM so far. Therefore, this study was conducted to construct a nomogram to predict the 3- and 5-year overall survival (OS) and cancer specific survival (CSS) of newly diagnosed BCLM patients, so as to provide a reference for clinical use.Methods The data of patients with initial diagnosis of BCLM between 2010 and 2016 were retrieved from the SEER database. Strictly following the inclusion and exclusion criteria, 1 994 patients were selected and randomly divided into model group (n=1 398) and validation group (n=596) at a ratio of 7∶3. The variables with statistical significance in univariate analysis were included in the multivariate Cox regression model, and the independent risk factors affecting the survival of BCLM patients were obtained. A nomogram for predicting OS and CSS was established based on the independent risk factors affecting the prognosis of BCLM patients. The reliability of the nomogram was evaluated by concordance index (C-index) and calibration curve.Results Age, race, marriage, grade, status of hormone receptors, surgery, chemotherapy, bone metastasis, brain metastasis and lung metastasis were independent prognostic factors for patients with BCLM (all P<0.05). Based on these factors, the nomogram was successfully constructed. The C-index of OS in model and validation groups were 0.709 and 0.731, and the C-index of CSS in model and validation groups were 0.709 and 0.732, respectively. Calibration curves also showed an excellent agreement between actual survival and nomogram prediction.Conclusion The established nomogram can accurately predict the prognosis in patients with initial diagnosis of BCLM. It may be helpful for clinicians to make individualized treatment plans.

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SONG Zhangjun, LIU Fende, WANG Huxia, WANG Xingguang, JIE Lu. Construction of a prognostic nomogram model for newly diagnosed patients with breast cancer liver metastases[J]. Chin J Gen Surg,2021,30(11):1274-1284.
DOI:10.7659/j. issn.1005-6947.2021.11.002

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History
  • Received:March 21,2021
  • Revised:May 10,2021
  • Adopted:
  • Online: December 24,2021
  • Published: