Improving Prognostic Value in Invasive Triple Negative Breast Cancer Through a Combined Nomogram Approach.

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2024-11-22 DOI:10.1016/j.clbc.2024.11.013

Lian Li, Zhi Liu, Kairong Chen, Yingjia Li

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引用次数: 0

Abstract

Objectives: To investigate the potential prognostic value of ultrasound (US) features in conjunction with pathological markers and to develop a preliminary working model for predicting poor outcomes in patients with invasive triple-negative breast cancer (TNBC).

Methods: From January 2012 to December 2018, we enrolled 209 TNBC patients treated with standard therapy, systematically gathered data on US parameters, stromal tumor-infiltrating lymphocytes (TILs), lymphovascular invasion (LVI) status, and other relevant information, and recorded follow-up data. A nomogram combining AJCC staging with US score, stromal TILs, and LVI was constructed and validated to predict poor outcomes, defined as recurrence or death, in patients with invasive TNBC.

Results: The US score of 4 was best related to poor outcomes in patients with TNBC (HR 3.87, P = .015). In the training set, the nomogram had a considerably greater prognostic value [area under the curve (AUC), 0.74 vs. 0.64, P = .045] than AJCC staging alone, and it was comparable to that of the validation set (AUC, 0.71 vs. 0.63, P = .804). An acceptable consistency between the nomogram-predicted and actual survival probabilities was found both in the training and validation sets, with Brier scores of 0.15 and 0.13, respectively.

Conclusions: The incorporation of AJCC stage with US score, stromal TILs, and LVI improved the model performance for predicting poor outcomes in patients with invasive TNBC compared to routine AJCC staging alone.

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联合影像学检查改善侵袭性三阴性乳腺癌的预后价值。

目的：探讨超声（US）特征与病理标志物的潜在预后价值，并建立一个初步的工作模型来预测侵袭性三阴性乳腺癌（TNBC）患者的不良预后。方法：2012年1月至2018年12月，纳入209例经标准治疗的TNBC患者，系统收集US参数、基质肿瘤浸润淋巴细胞（til）、淋巴血管侵袭（LVI）状态等相关信息，并记录随访数据。将AJCC分期与US评分、间质til和LVI相结合的nomogram图被构建并验证，以预测侵袭性TNBC患者的不良预后（定义为复发或死亡）。结果：美国评分4分与TNBC患者预后不良最相关（HR 3.87, P = 0.015）。在训练集中，nomogram预后价值[曲线下面积（area under the curve， AUC）， 0.74 vs. 0.64, P = 0.045]明显高于单纯的AJCC分期，且与验证集的预后价值相当（AUC, 0.71 vs. 0.63, P = 0.804）。在训练集和验证集中，均发现nomogram-predicted and actual survival probability之间存在可接受的一致性，Brier评分分别为0.15和0.13。结论：与单独的常规AJCC分期相比，AJCC分期与US评分、基质TILs和LVI的结合提高了模型预测侵袭性TNBC患者不良预后的性能。

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

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.