Clinical Value of Surgery and Establishment a Predictive Model for Breast Cancer Patients with Bone-Only Metastasis.

IF 2 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Discovery medicine Pub Date : 2023-02-01 DOI:10.24976/Discov.Med.202335174.8

Zongpan Wang, Rongxing Wu, Dan Qiu, Shaofang Zhou

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Abstract

Background: Whether to perform surgery on breast cancer with initial bone metastasis is heatedly debated. The aim of this study was to assess the efficacy of surgery to prolong survival time towards breast cancer patients with bone-only metastasis, and create a prognostic nomogram to predict long-term survival.

Methods: Patients diagnosed with bone-only metastatic breast cancer from 2010 to 2015 were included in this study. National Cancer Database (NCDB) was used to obtain patients' data.

Results: A total of 7751 patients were included for final analysis, among which 3114 (40.2%) patients had received specialized breast surgery and 4637 (59.8%) had not. Patients who had undergone surgery showed a superior overall survival (OS) compared to patients without surgery (multivariate: HR (hazard ratios) = 0.58; 95% CI (confidence interval) [0.54-0.62]; p < 0.001). Moreover, survival benefit from surgery was also true in almost all subgroups. Prognostic nomogram to individually predict patients' long-term survival rate exhibited an acceptable predictive capability, with a C-index around 0.7 both in training and validation cohorts. Clinicopathological factors included in the nomogram could discriminate patients into subgroup with different prognoses.

Conclusions: Our data suggests that surgery may enhance OS in patients with initial bone-only metastatic breast cancer. Additionally, the created nomogram showed an acceptable could predict patients' long term survival.

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乳腺癌骨转移手术的临床价值及预测模型的建立。

背景:早期骨转移的乳腺癌是否需要手术治疗一直是争论的焦点。本研究的目的是评估手术延长乳腺癌骨转移患者生存时间的效果，并创建预后nomogram来预测长期生存。方法:选取2010 - 2015年诊断为单纯骨转移性乳腺癌的患者。使用国家癌症数据库(NCDB)获取患者数据。结果:共纳入7751例患者进行最终分析，其中3114例(40.2%)患者接受过乳房专科手术，4637例(59.8%)患者未接受过乳房专科手术。与未接受手术的患者相比，接受手术的患者显示出更好的总生存期(OS)(多变量:HR(风险比)= 0.58;95% CI(置信区间)[0.54-0.62];P < 0.001)。此外，在几乎所有亚组中，手术的生存益处也是真实的。单独预测患者长期生存率的预后nomogram显示出可接受的预测能力，在训练和验证队列中C-index都在0.7左右。包括在nomogram临床病理因素可以区分不同预后的患者亚组。结论:我们的数据表明，手术可能会提高初始仅骨转移性乳腺癌患者的OS。此外，所创建的nomogram显示了一个可接受的预测患者长期生存的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Discovery medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

5.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Discovery Medicine publishes novel, provocative ideas and research findings that challenge conventional notions about disease mechanisms, diagnosis, treatment, or any of the life sciences subjects. It publishes cutting-edge, reliable, and authoritative information in all branches of life sciences but primarily in the following areas: Novel therapies and diagnostics (approved or experimental); innovative ideas, research technologies, and translational research that will give rise to the next generation of new drugs and therapies; breakthrough understanding of mechanism of disease, biology, and physiology; and commercialization of biomedical discoveries pertaining to the development of new drugs, therapies, medical devices, and research technology.