Making the most of your prognostic factors: Presenting a more accurate survival model for breast cancer patients

1992 ◽  
Vol 22 (3) ◽  
pp. 251-262 ◽  
Author(s):  
Karen L. Knorr ◽  
Susan G. Hilsenbeck ◽  
Charlotte R. Wenger ◽  
George Pounds ◽  
Teri Oldaker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Survival Model ◽  
Breast Cancer Patients

scholarly journals Surgery for primary tumor benefits survival for breast cancer patients with bone metastases: a large cohort retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhangheng Huang ◽  
Xin Zhou ◽  
Yuexin Tong ◽  
Lujian Zhu ◽  
Ruhan Zhao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Predictive Accuracy ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Risk Of Death ◽  
The Impact

Abstract Background The role of surgery for the primary tumor in breast cancer patients with bone metastases (BM) remains unclear. The purpose of this study was to determine the impact of surgery for the primary tumor in breast cancer patients with BM and to develop prognostic nomograms to predict the overall survival (OS) of breast cancer patients with BM. Methods A total of 3956 breast cancer patients with BM from the Surveillance, Epidemiology, and End Results database between 2010 and 2016 were included. Propensity score matching (PSM) was used to eliminate the bias between the surgery and non-surgery groups. The Kaplan-Meier analysis and the log-rank test were performed to compare the OS between two groups. Cox proportional risk regression models were used to identify independent prognostic factors. Two nomograms were constructed for predicting the OS of patients in the surgery and non-surgery groups, respectively. In addition, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the performance of nomograms. Result The survival analysis showed that the surgery of the primary tumor significantly improved the OS for breast cancer patients with BM. Based on independent prognostic factors, separate nomograms were constructed for the surgery and non-surgery groups. The calibration and ROC curves of these nomograms indicated that both two models have high predictive accuracy, with the area under the curve values ≥0.700 on both the training and validation cohorts. Moreover, DCA showed that nomograms have strong clinical utility. Based on the results of the X-tile analysis, all patients were classified in the low-risk-of-death subgroup had a better prognosis. Conclusion The surgery of the primary tumor may provide survival benefits for breast cancer patients with BM. Furthermore, these prognostic nomograms we constructed may be used as a tool to accurately assess the long-term prognosis of patients and help clinicians to develop individualized treatment strategies.

scholarly journals Prognostic Factors of Recurrence (Early and Late) and Death in Breast Cancer Patients in Iranian Women

2016 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Esmaeil Akbari ◽  
Atieh Akbari ◽  
Nahid Nafissi ◽  
Zeinab Shormeij ◽  
Soheila Sayad ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Iranian Women

Adjuvant Chemotherapy Guidance for pT1-3N0-1 Breast Cancer Patients with HR+, HER2- subtype: a study based on SEER database

2021 ◽  
Author(s):  
juanjuan Qiu ◽  
Li Xu ◽  
Yu Wang ◽  
Jia Zhang ◽  
Jiqiao Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Rank Test ◽  
Breast Cancer Patients ◽  
Group Score

Abstract Background Although the results of gene testing can guide early breast cancer patients with HR+, HER2- to decide whether they need chemotherapy, there are still many patients worldwide whose problems cannot be solved well by genetic testing. Methods 144 735 patients with HR+, HER2-, pT1-3N0-1 breast cancer from the Surveillance, Epidemiology, and End Results database were included from 2010 to 2015. They were divided into chemotherapy (n = 38 392) and no chemotherapy (n = 106 343) group, and after propensity score matching, 23 297 pairs of patients were left. Overall survival (OS) and breast cancer-specific survival (BCSS) were tested by Kaplan–Meier plot and log-rank test and Cox proportional hazards regression model was used to identify independent prognostic factors. A nomogram was constructed and validated by C-index and calibrate curves. Patients were divided into high- or low-risk group according to their nomogram score using X-tile. Results Patients receiving chemotherapy had better OS before and after matching (p < 0.05) but BCSS was not significantly different between patients with and without chemotherapy after matching: hazard ratio (HR) 1.005 (95%CI 0.897, 1.126). Independent prognostic factors were included to construct the nomogram to predict BCSS of patients without chemotherapy. Patients in the high-risk group (score > 238) can get better OS HR 0.583 (0.507, 0.671) and BCSS HR 0.791 (0.663, 0.944) from chemotherapy but the low-risk group (score ≤ 238) cannot. Conclusion The well-validated nomogram and a risk stratification model was built. Patients in the high-risk group should receive chemotherapy while patients in low-risk group may be exempt from chemotherapy.

Long-Term Survival and Prognostic Factors for 2170 Breast Cancer Patients Treated at Two Cancer Centers: (Milan and Houston)

1989 ◽  
Vol 75 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Natale Cascinelli ◽  
Eva Singletary ◽  
Marco Greco ◽  
Frederick Ames ◽  
Alessandro Testori ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Significant Interaction ◽  
Maximum Diameter ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Lack Of Information ◽  
Intercurrent Disease

Data on 2170 consecutive patients with breast cancer submitted to curative surgery with or without combined radiotherapy in the period 1968–1972 at the National Cancer Institute of Milan (Italy) and at the University of Texas M.D. Anderson Cancer Center of Houston (Texas, USA) were analyzed to evaluate the prognosis of breast cancer patients after loco-regional treatment only and to verify if different prognostic factors have the same relevance. Forty-four percent of patients were alive without evidence of disease at the end of the follow-up in both centers: 14% of patients treated in Milan died without evidence of breast cancer with an intercurrent disease, whereas the death rate for intercurrent disease was 27 % in Houston. Thirty-seven percent of the patients in Milan and 26% of the patients in Houston died from breast cancer. A considerable percentage of patients (23.4 % in Milano, 38.2% in Houston) had one or more of the required items not specified in the clinical chart. Since the lack of information was considered a possible source of bias, the series were divided into two groups: the first collecting patients with all information available, the second gathering patients with at least one of the required items missing. The latter group was defined « unknown ». Multivariate analysis of survival, carried out by means of Cox's regression model, showed that mortality of these patients for all causes was significantly affected by the following criteria: status of regional nodes (P = 2 × 10−18), unknown (P = 10−9), maximum diameter of primary tumor (P = 7 × 10−10), age of the patients (P = 10−4), site of primary (P = 0.01), and Center (P = 0.04). A significant interaction was found between center and a) age of the patients, b) menopausal status and c) unknown. The relative P values were 6 × 10−7 for age and center, 8 × 10−3 for menopausal and center, 3 × 10−2 for unknown and center. Multivariate analysis of breast cancer mortality was significantly affected by: status of regional nodes (P = 10−18), diameter of primary (P = 5 × 10−14), unknown (P = 2 × 10−13), center (P = 2 × 10−6), site of primary (P = 0.002), and age of the patients (P = 0.03). The same significant interaction as for mortality from all causes was found. It is concluded that comparability of results obtained in different institutions may be dependent on the standardization and availability of patients data. The lack of information may introduce considerable biases in the evaluation of results, as was shown by the relevance of the variable unknown on mortality for all causes and for breast cancer. As regards the number of positive lymph nodes as a criterion to define subgroups of patients with different risks of death, we were unable to identify a definite breaking point. The most widely used categorization of this variable (1–3 positive nodes and 4 or more positive) was not supported by our data.

Simultaneous Immunohistochemical Detection of Tumor Cells in Lymph Nodes and Bone Marrow Aspirates in Breast Cancer and Its Correlation With Other Prognostic Factors

2001 ◽  
Vol 19 (4) ◽  
pp. 960-971 ◽  
Author(s):  
Bernd Gerber ◽  
Annette Krause ◽  
Heiner Müller ◽  
Dagmar Richter ◽  
Toralf Reimer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients

PURPOSE: We studied the prognostic and predictive value of immunohistochemically detected occult tumor cells (OTCs) in lymph nodes and bone marrow aspirates obtained from node-negative breast cancer patients. All were classified as distant metastases-free using conventional staging methods. PATIENTS AND METHODS: A total of 484 patients with pT1-2N0M0 breast cancer and 70 with pT1-2N1M0 breast cancer and a single affected lymph node participated in our trial. Ipsilateral axillary lymph nodes and intraoperatively aspirated bone marrow were examined. All samples were examined for OTCs using monoclonal antibodies to cytokeratins 8, 18, 19. Immunohistological findings were correlated with other prognostic factors. The mean follow-up was 54 ± 24 months. RESULTS: OTCs were detected in 180 (37.2%) of 484 pT1-2N0M0 patients: in the bone marrow of 126 patients (26.0%), in the lymph nodes of 31 patients (6.4%), and in bone marrow and lymph nodes of 23 (4.8%) patients. Of the 70 patients with pT1-2N1MO breast cancer and a single involved lymph node, OTCs were identified in the bone marrow of 26 (37.1%). The ability to detect tumor cells increased with the following tumor features: larger size, poor differentiation, and higher proliferation. Tumors of patients with OTCs more frequently demonstrated lymph node invasion, blood vessel invasion, higher urokinase-type plasminogen activator levels, and increased PAI-1 concentrations. Patients with detected OTCs showed reduced disease-free survival (DFS) and overall survival (OAS) rates that were comparable to those observed in patients who had one positive lymph node. Multivariate analysis of prognostic factors revealed that OTCs, histological grading, and tumor size are significant predictors of DFS; OTCs and grading of OAS. CONCLUSION: OTCs detected by simultaneous immunohistochemical analysis of axillary lymph nodes and bone marrow demonstrate independent metastatic pathways. Although OTCs were significantly more frequent in patients with other unfavorable prognostic factors, they were confirmed as an independent prognostic factor for pT1-2N0M0, R0 breast cancer patients.

Deep survival model indentified the prognostic subgroups in triple-negative breast cancer patients

2018 ◽  
Vol 92 ◽  
pp. S26
Author(s):  
I. Kim ◽  
J.M. Ryu ◽  
H.J. Choi ◽  
J.M. Kim ◽  
S.K. Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Survival Model ◽  
Breast Cancer Patients
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