Development and validation of nomograms to predict survival in patients with invasive micropapillary carcinoma of the breast

Autor: Zhihui Zhang, Jia-yuan Sun, Yulin Huang, Yixin Cheng, Pengkun Zhang, Ru Tang, Feng Chi, Zhenyu He
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: BMJ Open, Vol 13, Iss 2 (2023)
Druh dokumentu: article
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2022-065312
Popis: Objectives The present study aimed to develop and validate nomograms to predict the survival of patients with breast invasive micropapillary carcinoma (IMPC) to aid objective decision-making.Design Prognostic factors were identified using Cox proportional hazards regression analyses and used to construct nomograms to predict overall survival (OS) and breast cancer-specific survival (BCSS) at 3 and 5 years. Kaplan-Meier analysis, calibration curves, the area under the curve (AUC) and the concordance index (C-index) evaluated the nomograms’ performance. Decision curve analysis (DCA), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to compare the nomograms with the American Joint Committee on Cancer (AJCC) staging system.Setting Patient data were collected from the Surveillance, Epidemiology, and End Results (SEER) database. This database holds data related to the incidence of cancer acquired from 18 population-based cancer registries in the US.Participants We ruled out 1893 patients and allowed the incorporation of 1340 patients into the present study.Results The C-index of the AJCC8 stage was lower than that of the OS nomogram (0.670 vs 0.766) and the OS nomograms had higher AUCs than the AJCC8 stage (3 years: 0.839 vs 0.735, 5 years: 0.787 vs 0.658). On calibration plots, the predicted and actual outcomes agreed well, and DCA revealed that the nomograms had better clinical utility compared with the conventional prognosis tool. In the training cohort, the NRI for OS was 0.227, and for BCSS was 0.182, while the IDI for OS was 0.070, and for BCSS was 0.078 (both p
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