癌症骨、软组织肿瘤科骨转移患者生存率评估、预后因素评价及预后预测诺模图构建：天津市8年单中心经验

IF 1.9 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Breast Journal Pub Date : 2022-01-31 DOI:10.1155/2022/7140884

Yao Xu, Haixiao Wu, Guijun Xu, Z. Yin, Xin Wang, V. Chekhonin, K. Peltzer, Shu Li, Hui-yan Li, Jin Zhang, Wenjuan Ma, Chao Zhang

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引用次数: 1

摘要

目的癌症骨转移仍是全球关注的问题。准确的生存率估计将有利于临床决策，尤其是对有潜在手术指征的患者。基于中国的回顾性队列，本研究旨在构建癌症骨转移患者的预后预测列线图。方法回顾性选择我科2009～2017年间诊断为癌症骨转移的患者。将总队列分为构建队列和验证队列（比例7 : 3）。构建了一个诺模图来预测生存概率，并验证了模型的性能。结果共有343名患者入选，其中243名患者和100名患者分别进入构建和验证队列。总队列的中位总生存期为63.2个月（95%置信区间：52.4–74.0）。ALP升高（HR = 1.71，95%置信区间：1.16-2.51；P=0.006），癌症无需手术治疗（HR = 2.19，95%置信区间：1.30–3.70；P=0.003）、同步骨转移（HR = 1.98，95%置信区间：1.22–3.22；P=0.006）和肝转移（HR = 1.68，95%置信区间：1.20-2.37；P=0.003）是生存率较差的独立预后因素。独立预测因素和其他五个因素（包括诊断时的年龄、ER状态、PR状态、Her-2状态和双磷酸盐的表现）被纳入构建列线图。在构建队列和验证队列中，C指数分别为0.714（95%CI:0.636-0.792）和0.705（95%CI:0.705）。所有的校准曲线都接近45度线，这表明校准是令人满意的。结论对癌症骨转移患者的预后进行了回顾性研究。确定了四个独立的预后因素，并构建了一个具有令人满意的判别和校准的预后列线图。该模型可用于生存率估计和个体化治疗计划。

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Survival Estimation, Prognostic Factors Evaluation, and Prognostic Prediction Nomogram Construction of Breast Cancer Patients with Bone Metastasis in the Department of Bone and Soft Tissue Tumor: A Single Center Experience of 8 Years in Tianjin, China

Purpose Bone metastasis in breast cancer remains globally concerned. Accurate survival estimation would be beneficial for clinical decision-making, especially for the patients with potential indications of surgery. Based on a retrospective cohort from China, the study aimed to construct a prognostic prediction nomogram for breast cancer patients with bone metastasis. Methods Breast cancer patients with bone metastasis diagnosed between 2009 and 2017 in our department were retrospectively selected. The total cohort was divided into construction and validation cohorts (ratio 7 : 3). A nomogram was constructed to predict the probability of survival, and the performance of model was validated. Results A total of 343 patients were enrolled with 243 and 100 patients in construction and validation cohorts, respectively. The median overall survival for the total cohort was 63.2 (95% CI: 52.4–74.0) months. Elevated ALP (HR = 1.71, 95% CI: 1.16–2.51; P=0.006), no surgery for breast cancer (HR = 2.19, 95% CI: 1.30–3.70; P=0.003), synchronous bone metastasis (HR = 1.98, 95% CI: 1.22–3.22; P=0.006), and liver metastasis (HR = 1.68, 95% CI: 1.20–2.37; P=0.003) were independent prognostic factors for worse survival. The independent predictors and other five factors (including age at diagnosis, ER status, PR status, Her-2 status, and the performance of bisphosphonate) were incorporated to construct the nomogram. The C-index was 0.714 (95% CI: 0.636–0.792) and 0.705 (95% CI: 0.705) in the construction cohort and validation cohort, respectively. All the calibration curves were close to the 45-degree line, which indicated satisfactory calibration. Conclusion A retrospective study aiming at prognostic estimation of breast cancer patients with bone metastasis was designed. Four independent prognostic factors were identified and a prognostic nomogram was constructed with satisfactory discrimination and calibration. The model could be used in survival estimation and individualized treatment planning.

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来源期刊

Breast Journal 医学-妇产科学

CiteScore

4.00

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.