A novel nomogram and survival analysis for different lymph node status in breast cancer based on the SEER database.

IF 4 3区 医学 Q1 OBSTETRICS & GYNECOLOGY
Breast Cancer Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI:10.1007/s12282-024-01591-5
Lizhi Teng, Juntong Du, Shuai Yan, Peng Xu, Jiangnan Liu, Xinyang Zhao, Weiyang Tao
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引用次数: 0

Abstract

Introduction: The axillary lymph node status (ALNS) and internal mammary lymph nodes (IMLN) expression associated with breast cancer are closely linked to prognosis. This study aimed to establish a nomogram to predict survival at 3, 5, and 10 years in patients with various lymph node statuses.

Methods: We obtained data from patients with breast cancer between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER database). Chi-square analysis was performed to test for differences in the pathological characteristics of the groups, and Kaplan-Meier analysis and the log-rank test were used to plot and compare the correlation between overall survival (OS) and breast cancer specific survival (BCSS). The log-rank test was used for the univariate analysis, and statistically significant characteristics were included in the multivariate and Cox regression analyses. Finally, Independent factor identification was included in constructing the nomogram using R studio 4.2.0; area under curve (AUC) values were calculated, and receiver operating characteristic (ROC) curve, calibration, and decision curve analysis (DCA) curves were plotted for evaluation.

Results: A total of 279,078 patients were enrolled and analysed, demonstrating that the isolated tumour cells (ITC) group had clinicopathological characteristics similar to those of micrometastases (Mic). Multivariate analysis was performed to identify each subgroup's independent risk factors and construct a nomogram. The AUC values were 74.7 (95% CI 73.6-75.8), 72.8 (95% CI 71.9-73.8), and 71.2 (95% CI 70.2-72.2) for 3-, 5-, and 10-year OS, respectively, and 82.2 (95% CI 80.9-83.6), 80.1 (95% CI 79.0-81.2), and 75.5 (95% CI 74.3-76.8) for BCSS in overall breast cancer cases, respectively. AUC values for 3-, 5-, and 10-year OS in the ITC group were 64.8 (95% CI 56.5-73.2), 67.7 (95% CI 62.0-73.4), and 65.4 (95% CI 60.0-70.7), respectively. For those in the Mic group, AUC values for 3-, 5-, and 10-year OS were 72.9 (95% CI 70.7-75.1), 72.4 (95% CI 70.6-74.1), and 71.3 (95% CI 69.6-73.1), respectively, and AUC values for BCSS were 77.8 (95% CI 74.9-80.7), 75.7 (95% CI 73.5-77.9), and 70.3 (95% CI 68.0-72.6), respectively. In the IMLN group, AUC values for 3-, 5-, and 10-year OS were 75.2 (95% CI 71.7-78.7), 73.4 (95% CI 70.0-76.8), and 74.0 (95% CI 69.6-78.5), respectively, and AUC values for BCSS were 76.6 (95% CI 73.0-80.3), 74.1 (95% CI 70.5-77.7), and 74.7 (95% CI 69.8-79.5), respectively. The ROC, calibration, and DCA curves verified that the nomogram had better predictability and benefits.

Conclusion: This study is the first to investigate the predictive value of different axillary lymph node statuses and internal mammary lymph node metastases in breast cancer, providing clinicians with additional aid in treatment decisions.

Abstract Image

基于 SEER 数据库的乳腺癌不同淋巴结状态的新提名图和生存分析。
简介与乳腺癌相关的腋窝淋巴结状态(ALNS)和乳腺内淋巴结(IMLN)表达与预后密切相关。本研究旨在建立一个提名图,以预测不同淋巴结状态患者的 3 年、5 年和 10 年生存率:我们从监测、流行病学和最终结果(SEER)数据库中获得了 2004 年至 2015 年期间乳腺癌患者的数据。采用卡普兰-梅耶尔分析和对数秩检验来绘制和比较总生存期(OS)与乳腺癌特异性生存期(BCSS)之间的相关性。单变量分析采用对数秩检验,具有统计学意义的特征则纳入多变量分析和 Cox 回归分析。最后,在使用 R studio 4.2.0 构建提名图时纳入了独立因素识别;计算了曲线下面积(AUC)值,并绘制了接收者操作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)曲线以进行评估:共对 279,078 例患者进行了登记和分析,结果显示孤立肿瘤细胞(ITC)组的临床病理特征与微转移(Mic)组相似。多变量分析确定了每个亚组的独立风险因素,并构建了一个提名图。3年、5年和10年OS的AUC值分别为74.7(95% CI 73.6-75.8)、72.8(95% CI 71.9-73.8)和71.2(95% CI 70.2-72.2),整体乳腺癌病例BCSS的AUC值分别为82.2(95% CI 80.9-83.6)、80.1(95% CI 79.0-81.2)和75.5(95% CI 74.3-76.8)。ITC组3年、5年和10年OS的AUC值分别为64.8(95% CI 56.5-73.2)、67.7(95% CI 62.0-73.4)和65.4(95% CI 60.0-70.7)。Mic组患者3年、5年和10年OS的AUC值分别为72.9(95% CI 70.7-75.1)、72.4(95% CI 70.6-74.1)和71.3(95% CI 69.6-73.1),BCSS的AUC值分别为77.8(95% CI 74.9-80.7)、75.7(95% CI 73.5-77.9)和70.3(95% CI 68.0-72.6)。在IMLN组中,3年、5年和10年OS的AUC值分别为75.2(95% CI 71.7-78.7)、73.4(95% CI 70.0-76.8)和74.0(95% CI 69.6-78.5),BCSS的AUC值分别为76.6(95% CI 73.0-80.3)、74.1(95% CI 70.5-77.7)和74.7(95% CI 69.8-79.5)。ROC、校准和 DCA 曲线验证了提名图具有更好的预测性和效益:本研究首次调查了乳腺癌不同腋窝淋巴结状态和乳腺内淋巴结转移的预测价值,为临床医生的治疗决策提供了更多帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Breast Cancer
Breast Cancer ONCOLOGY-OBSTETRICS & GYNECOLOGY
CiteScore
6.70
自引率
2.50%
发文量
105
审稿时长
6-12 weeks
期刊介绍: Breast Cancer, the official journal of the Japanese Breast Cancer Society, publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research, seeking to develop a new focus and new perspectives for all who are concerned with breast cancer. The journal welcomes all original articles describing clinical and epidemiological studies and laboratory investigations regarding breast cancer and related diseases. The journal will consider five types of articles: editorials, review articles, original articles, case reports, and rapid communications. Although editorials and review articles will principally be solicited by the editors, they can also be submitted for peer review, as in the case of original articles. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.
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