Assessing Surgical Benefits and Creating a Prognostic Model for Breast Cancer with Lung-only Metastasis: An Analysis of the National Cancer Database.

IF 0.9 4区 医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2024-01-01 DOI:10.62713/aic.3365
Wangyan Zhong, Guansheng Zhong, Wanlin Ye, Xueying Jin
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Abstract

Aim: The decision to perform surgery on breast cancer patients with lung-only metastasis is a subject of ongoing debate. Our investigation seeks to assess the survival rates following surgical intervention among individuals diagnosed with breast cancer experiencing isolated metastasis to the lungs. Additionally, we endeavor to devise a predictive nomogram aimed at forecasting the long-term survival.

Methods: We analyzed patients diagnosed with primary lung metastases from breast cancer between 2010 and 2015, utilizing datasets obtained from the National Cancer Database (NCDB). We employed the Cox proportional hazards regression model and the Kaplan-Meier method to analyze survival data. Additionally, we constructed nomograms to forecast survival outcomes.

Results: The study comprised 2403 patients, with 1058 (44.0%) undergoing breast-specific surgery and 1345 (56.0%) not receiving surgical treatment. The group that underwent surgical procedures exhibited a significantly enhanced overall survival (OS) compared to the non-surgery group (multivariate analysis: hazard ratio [HR] = 0.64; 95% confidence interval [CI], 0.54-0.75; p < 0.001). Surgical intervention consistently improved survival across nearly all patient subgroups. The research successfully established a predictive nomogram designed to calculate the likelihood of long-term survival, attaining a concordance index (C-index) of approximately 0.7 in both validation and training cohorts. By integrating multiple clinicopathological variables, the nomogram efficiently classified patients into categories reflecting different survival forecasts.

Conclusions: The findings of this investigation support the notion that surgical treatment can enhance the overall survival of patients with initial lung-only metastasis from breast cancer. The investigation further introduces a nomogram demonstrating reasonable accuracy in forecasting long-term survival of patients in this cohort.

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评估乳腺癌肺转移的手术益处并创建预后模型:全国癌症数据库分析》。
目的:对于是否对仅肺部转移的乳腺癌患者实施手术一直存在争议。我们的调查旨在评估确诊为肺部孤立转移的乳腺癌患者手术治疗后的生存率。此外,我们还致力于设计一个预测性提名图,旨在预测长期生存率:我们利用从美国国家癌症数据库(NCDB)获得的数据集,对 2010 年至 2015 年期间确诊为乳腺癌原发性肺转移的患者进行了分析。我们采用 Cox 比例危险回归模型和 Kaplan-Meier 法分析生存数据。此外,我们还构建了预测生存结果的提名图:研究对象包括2403名患者,其中1058人(44.0%)接受了乳腺特异性手术,1345人(56.0%)未接受手术治疗。与未接受手术治疗组相比,接受手术治疗组的总生存率(OS)明显提高(多变量分析:危险比 [HR] = 0.64;95% 置信区间 [CI],0.54-0.75;P < 0.001)。在几乎所有患者亚组中,手术干预都能持续改善生存率。该研究成功建立了一个预测性提名图,旨在计算长期生存的可能性,在验证组和训练组中的一致性指数(C-index)均达到约 0.7。通过整合多种临床病理变量,提名图有效地将患者分为不同类别,反映了不同的生存预测:结论:本研究结果支持手术治疗可提高乳腺癌初次肺转移患者总生存率的观点。调查还进一步引入了一个提名图,该提名图在预测该组患者的长期生存率方面显示出了合理的准确性。
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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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