Nomograms to estimate long-term overall survival and breast cancer-specific survival of patients with luminal breast cancer
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Wei Sun1,2,3,*, Yi-Zhou Jiang1,2,3,*, Yi-Rong Liu1,2,3,*, Ding Ma1,2,3, Zhi-Ming Shao1,2,3,4
1Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
2Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, P.R. China
3Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
4Institutes of Biomedical Sciences, Fudan University, Shanghai, P.R. China
*These authors contributed equally to this work
Zhi-Ming Shao, e-mail: [email protected]
Keywords: nomogram, luminal breast cancer, overall survival, breast cancer-specific survival
Received: December 02, 2015 Accepted: February 13, 2016 Published: March 07, 2016
Luminal breast cancer constitutes a group of highly heterogeneous diseases with a sustained high risk of late recurrence. We aimed to develop comprehensive and practical nomograms to better estimate the long-term survival of luminal breast cancer.
Patients with luminal breast cancer diagnosed between 1990 and 2006 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into the training (n = 87,867) and validation (n = 88,215) cohorts. The cumulative incidence function (CIF) and a competing-risks model were used to estimate the probability of breast cancer-specific survival (BCSS) and death from other causes. We integrated significant prognostic factors to build nomograms and subjected the nomograms to bootstrap internal validation and to external validation.
We screened 176,082 luminal breast cancer cases. The 5- and 10-year probabilities of overall death were 0.089 and 0.202, respectively. The 5- and 10-year probabilities of breast cancer-specific mortality (BCSM) were 0.053 and 0.112, respectively. Nine independent prognostic factors for both OS and BCSS were integrated to construct the nomograms. The calibration curves for the probabilities of 5- and 10-year OS and BCSS showed excellent agreement between the nomogram prediction and actual observation. The C-indexes of the nomograms were high in both internal validation (0.732 for OS and 0.800 for BCSS) and external validation (0.731 for OS and 0.794 for BCSS).
We established nomograms that accurately predict OS and BCSS for patients with luminal breast cancer. The nomograms can identify patients with higher risk of late overall mortality and BCSM, helping physicians in facilitating individualized treatment.
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