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

Area of Science:

• Oncology
• Biostatistics
• Epidemiology

Background:

• Triple-negative invasive ductal breast carcinoma (TNIDC) poses a significant challenge in elderly patients.
• Accurate prognostic tools are crucial for tailoring treatment strategies in this demographic.

Purpose of the Study:

• To develop and validate a nomogram for predicting overall survival in elderly patients with nonmetastatic TNIDC.
• To compare the predictive accuracy of the nomogram against the established TNM staging system.

Main Methods:

• Utilized data from 12,165 elderly patients with nonmetastatic TNIDC from the SEER database (2010-2019).
• Employed stepwise Cox regression for variable selection and constructed nomograms using training and validation cohorts.
• Performed univariate, multivariate Cox analyses, and survival analysis for risk stratification.

Main Results:

• Identified eleven predictive factors for nomogram construction, demonstrating superior discrimination (C-index 0.741/0.765) compared to TNM staging (C-index 0.708/0.725).
• The nomogram showed good prognostic accuracy and clinical applicability in both training and validation cohorts.
• Significant differences in overall survival were observed between high- and low-risk groups (p < 0.001).

Conclusions:

• The developed nomogram serves as a reliable tool for individual prognostication in elderly patients with M0-stage TNIDC.
• The model's applicability may be limited to the American population studied.