Survival Risk Score for Invasive Nonmetastatic Breast Cancer: A Real-World Analysis.

IF 3.2 Q2 ONCOLOGY JCO Global Oncology Pub Date : 2024-10-01 Epub Date: 2024-10-31 DOI:10.1200/GO.23.00390
Lucia Mangone, Fortunato Morabito, Giovanni Tripepi, Graziella D'Arrigo, Santina Maria Grazia Romeo, Isabella Bisceglia, Maria Barbara Braghiroli, Francesco Marinelli, Giancarlo Bisagni, Antonino Neri, Carmine Pinto
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Abstract

Purpose: This study aimed to develop a multivariable, weighted overall survival (OS) risk score (SRS) for nonmetastatic (M0) invasive breast cancer (M0-BC, SRSM0-BC).

Materials and methods: This study included a training (1,890 patients) and a validation cohort (850 patients) from the Reggio Emilia Cancer Registry (RE-CR). Ten traditional prognostic variables were evaluated.

Results: In the training set, all the variables but the human epidermal growth factor receptor were significantly associated with OS at univariable analysis. A multivariable model identified an increased death risk for estrogen receptor (hazard ratio [HR], 2.0 [95% CI, 1.1 to 3.1]; P = .021), tumor stages T2-T3 (HR, 2.4 [95% CI, 1.3 to 4.7]; P = .009) and T4 (HR, 5.1 [95% CI, 2.0 to 13.0]; P < .001), and age >74 years (HR, 5.7 [95% CI, 4.0 to 8.2]; P < .001). By assigning scores according to HRs, four risk categories were generated (P for trend <.001). The HRs of death in the high- (282 patients, 15.6%), intermediate-high (275 patients, 15.2%), and intermediate-risk (349 patients, 19.2%) categories patients were, respectively, 27.3, 12.9, and 3.5 times higher, compared with the low-risk (909 patients, 50%) group. Harrell'C index was 81.1%, and the explained variation in mortality was 66.6. Internal cross-validation performed on the accrual index dates yielded a Harrell'C index ranging from 79.5% to 82.3% and an explained variation in mortality ranging from 60.3% to 69.4%. In the validation set, the same risk categories (P for trend <.001) were devised. The Harrell'C index and the explained variation in mortality were 76.1% and 53.7%, respectively, in the whole cohort, maintaining an elevated percentage according to the two accrual index dates.

Conclusion: SRSM0-BC using the real-world RE-CR data set may represent a low-cost, accessible, globally applicable model in daily clinical practice, helping to prognostically stratify patients with invasive M0-BC.

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浸润性非转移性乳腺癌的生存风险评分:真实世界分析
目的:本研究旨在为非转移性(M0)浸润性乳腺癌(M0-BC,SCSM0-BC)制定一个多变量加权总生存(OS)风险评分(SRS):这项研究包括来自雷焦艾米利亚癌症登记处(Reggio Emilia Cancer Registry,RE-CR)的训练队列(1,890 名患者)和验证队列(850 名患者)。对十个传统预后变量进行了评估:结果:在训练集中,除人表皮生长因子受体外,所有变量都与单变量分析中的OS显著相关。多变量模型发现,雌激素受体(危险比 [HR],2.0 [95% CI,1.1 至 3.1];P = .021)、肿瘤分期 T2-T3 (HR,2.4 [95% CI, 1.3 to 4.7]; P = .009) 和 T4 (HR, 5.1 [95% CI, 2.0 to 13.0]; P < .001),以及年龄大于 74 岁 (HR, 5.7 [95% CI, 4.0 to 8.2]; P < .001)。根据 HRs 进行评分后,产生了四个风险类别(P 为趋势 P 为趋势 结论:SRSM0-BC使用真实世界的RE-CR数据集,可代表一种低成本、可访问、全球适用的日常临床实践模型,有助于对侵袭性M0-BC患者进行预后分层。
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来源期刊
JCO Global Oncology
JCO Global Oncology Medicine-Oncology
CiteScore
6.70
自引率
6.70%
发文量
310
审稿时长
7 weeks
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