Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11338-11348
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11338
Nomogram for predicting overall survival in Chinese triple-negative breast cancer patients after surgery
Wei-Xun Lin, Yan-Na Xie, Yao-Kun Chen, Jie-Hui Cai, Juan Zou, Jie-Hua Zheng, Yi-Yuan Liu, Zhi-Yang Li, Ye-Xi Chen
Wei-Xun Lin, Yao-Kun Chen, Jie-Hui Cai, Juan Zou, Jie-Hua Zheng, Yi-Yuan Liu, Zhi-Yang Li, Ye-Xi Chen, Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Yan-Na Xie, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Author contributions: Lin WL, Xie YN, Chen YX, Li ZY, Liu YY, and Cai JH designed the study and conceived the project; Zou J, Zheng JH, Chen YK, and Xie YN performed the experiments and analyzed the data; Lin WX and Xie YN drafted the manuscript; All authors have read and approved the manuscript.
Supported by the Special Fund Project of Guangdong Science and Technology, No. 210728156901524, and No. 210728156901519; Medical Scientific Research Foundation of Guangdong Province, China, No. A2021432, and No. B2021448; Shantou Medical Science and Technology Planning Project, No. 210521236491457, and No. 210625106490696.
Institutional review board statement: Not applicable, Patient data comes from the SEER*stat version 8.3.5.
Informed consent statement: Not applicable, Patient data comes from the SEER*stat version 8.3.5.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ye-Xi Chen, MD, Doctor, Department of Thyroid, Breast and Hernia Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou 515041, China. yxchen3@stu.edu.cn
Received: September 12, 2021
Peer-review started: September 12, 2021
First decision: January 10, 2022
Revised: January 25, 2022
Accepted: August 6, 2022
Article in press: August 6, 2022
Published online: November 6, 2022
Processing time: 409 Days and 14.9 Hours
Abstract
BACKGROUND

There are few nomograms for the prognosis of Chinese patients with triple-negative breast cancer (TNBC).

AIM

To construct and validate a nomogram for overall survival (OS) of Chinese TNBC patients after surgery.

METHODS

This study used the data of SEER*stat 8.3.5 and selected Chinese patients with TNBC operated on between 2010 and 2015. Univariate and multivariate Cox proportional hazard regression models were used. The identified variables were integrated to form a predictive nomogram and risk stratification model; it was assessed with C-indexes and calibration curves.

RESULTS

The median and maximal OS of the 336 patients was 39 and 83 mo, respectively. The multivariate analysis showed that age (P = 0.043), marital status (P = 0.040), tumor localization (P = 0.030), grade (P = 0.035), T classification (P = 0.012), and N classification (P = 0.002) were independent prognostic factors. The six variables were combined to construct a 1-, 3- and 5-year OS nomogram. The C-indexes of the nomogram to predict OS were 0.766 and compared to the seventh edition staging system, which was higher (0.766 vs 0.707, P < 0.001). In order to categorize patients into different prognostic groups, a risk stratification model was created. There was a significant difference between the Kaplan–Meier curves of the entire cohort and each disease stage according to the nomogram.

CONCLUSION

The nomogram provided prognostic superiority over the traditional tumor, node and metastasis system. It could help clinicians make individual OS or risk predictions for Chinese TNBC patients after surgery.

Keywords: Triple-negative breast cancer; Chinese; nomogram; Risk stratification; Overall survival

Core tip: This study aimed to construct and validate a nomogram for overall survival (OS) of triple-negative breast cancer (TNBC) patients after surgery. The data from SEER*stat 8.3.5 of selected Chinese surgical patients with TNBC between 2010 and 2015 were used. The multivariate analysis showed that age (P = 0.043), marital status (P = 0.040), tumor localization (P = 0.030), grade (P = 0.035), T classification (P = 0.012), and N classification (P = 0.002) were independent prognostic factors. A risk stratification model was generated. The C-indexes of the nomogram to predict OS were 0.766 and compared to the seventh edition tumor, node, metastasis (TNM) staging system, which was higher (0.766 vs 0.707, P < 0.001). The nomogram provided a clear prognostic superiority over the traditional TNM system.