Abstract
Purpose: Nomogram prognostic models could greatly facilitate risk stratification and treatment strategies for cancer patients. We developed and validated a new nomogram prognostic model, named NCCBM, for breast cancer patients with brain metastasis (BCBM) using a large BCBM cohort from the SEER (Surveillance, Epidemiology, and End Results) database.Patients and Methods: Clinical data for 975 patients diagnosed from 2011 to 2014 were used to develop the nomogram prognostic model. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The results were validated using an independent cohort of 542 BCBM patients diagnosed from 2014 to 2015.Results: The following variables were selected in the final prognostic model: age, race, surgery, radiation therapy, chemotherapy, laterality, grade, molecular subtype, and extracranial metastatic sites. The C-index for the model described here was 0.69 (95% CI, 0.67 to 0.71). The calibration curve for probability of survival showed good agreement between prediction by nomogram and actual observation. The model was validated in an independent validation cohort with a C-index of 0.70 (95% CI, 0.68 to 0.73).Conclusion: We developed and validated a nomogram prognostic model for BCBM patients, and the proposed nomogram resulted in good performance.
Highlights
Breast cancer is the most frequently diagnosed cancer in women worldwide and the second leading cause of cancer-related mortality in women in the United States (1)
We investigated the sociodemographic and clinicopathologic predictors associated with breast cancer patients with brain metastasis (BCBM) and constructed a robust nomogram for predicting BCBM survival at 6 months, 1 year, and 2 years
We found the prognostic variables for BCBM were as follows: age, race, surgery, radiation therapy, chemotherapy, laterality, grade, molecular subtype, and extracranial metastatic sites
Summary
Breast cancer is the most frequently diagnosed cancer in women worldwide and the second leading cause of cancer-related mortality in women in the United States (1). About 5 to 15% of women with breast cancer were diagnosed with central nervous system (CNS) metastasis; the incidence of breast cancer patients with brain metastasis (BCBM) was reported to be as high as 30% (2). The development of brain metastasis in breast cancer patients results in a significant reduction in overall survival duration (3). The median survival time for all subtypes of patients with breast cancer with untreated brain metastasis is only 10 months and varies with different clinical parameters (3).
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