Survival nomogram for patients with de novo metastatic breast cancer based on the SEER database and an external...

Area of Science:

• Oncology
• Biostatistics

Background:

• 5-10% of patients are diagnosed with de novo metastatic breast cancer (MBC) at initial diagnosis.
• Accurate prediction of overall survival (OS) is crucial for guiding treatment decisions in these patients.

Purpose of the Study:

• To develop and validate a nomogram for predicting OS in patients with de novo MBC.
• To compare the predictive performance of the nomogram against the AJCC-TNM staging system.

Main Methods:

• Retrospective analysis of 9435 patients with de novo MBC from the SEER database.
• Nomogram development using independent prognostic factors identified through multivariate analysis.
• Validation of predictive accuracy using concordance index (C-index), AUC, and calibration curves.
• Evaluation of clinical utility using decision curve analysis (DCA).

Main Results:

• Key predictors for OS included age, pathological type, grade, TNM stage, molecular subtype, and metastasis sites.
• The nomogram achieved a C-index of 0.688 in the training cohort and 0.875 in the validation cohort.
• The nomogram demonstrated superior net gains compared to the AJCC-TNM staging system.

Conclusions:

• The developed nomogram is a valuable tool for predicting OS in patients with de novo MBC.
• The nomogram shows favorable predictive and discriminative abilities.
• Further validation in diverse populations and prospective studies is recommended.