Development and validation of survival nomograms in elder triple-negative invasive ductal breast carcinoma patients

Expert Rev Anticancer Ther. 2024 Mar-Apr;24(3-4):193-203. doi: 10.1080/14737140.2024.2320815. Epub 2024 Feb 23.

Abstract

Background: We aimed to develop a nomogram to predict the overall survival of elderly patients with Triple-negative invasive ductal breast carcinoma (TNIDC).

Research design and methods: 12165 elderly patients with nonmetastatic TNIDC were retrieved from the SEER database from 2010 to 2019 and were randomly assigned to training and validation cohorts. Stepwise Cox regression analysis was used to select variables for the nomogram based on the training cohort. Univariate and multivariate Cox analyses were used to calculate the correlation between variables and prognosis of the patients. Survival analysis was performed for high- and low-risk subgroups based on risk score.

Results: Eleven predictive factors were identified to construct our nomograms. Compared with the TNM stage, the discrimination of the nomogram revealed good prognostic accuracy and clinical applicability as indicated by C-index values of 0.741 (95% CI 0.728-0.754) against 0.708 (95% CI 0.694-0.721) and 0.765 (95% CI 0.747-0.783) against 0.725 (95% CI 0.705-0.744) for the training and validation cohorts, respectively. Differences in OS were also observed between the high- and low-risk groups (p < 0.001).

Conclusion: The proposed nomogram provides a convenient and reliable tool for individual evaluations for elderly patients with M0_stage TNIDC. However, the model may only for Americans.

Keywords: SEER database; Triple-negative invasive ductal breast carcinoma; nomogram; predictive factors; prognostic model.