Cargando…
Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases
BACKGROUND: Bone metastases (BM) from malignant tumors could disrupt the balance between osteoclasts and osteoblasts and affect bone homeostasis. Malignant breast cancer (BC) is rare in male patients, and co-occurrence of BM is even rarer. Given its low incidence, there is limited research evaluatin...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691876/ https://www.ncbi.nlm.nih.gov/pubmed/36440188 http://dx.doi.org/10.3389/fendo.2022.1013338 |
_version_ | 1784837127713849344 |
---|---|
author | Gao, Bing Ou, Xiao-lan Li, Mu-feng Wang, Meng-die Huang, Fei |
author_facet | Gao, Bing Ou, Xiao-lan Li, Mu-feng Wang, Meng-die Huang, Fei |
author_sort | Gao, Bing |
collection | PubMed |
description | BACKGROUND: Bone metastases (BM) from malignant tumors could disrupt the balance between osteoclasts and osteoblasts and affect bone homeostasis. Malignant breast cancer (BC) is rare in male patients, and co-occurrence of BM is even rarer. Given its low incidence, there is limited research evaluating risk and prognosis. Despite the widespread application of nomograms to predict uncommon malignancies, no studies have constructed predictive models focusing on the diagnosis and prognosis of male breast cancer with bone metastases (MBCBM). METHODS: This study selected all male breast cancer patients (MBC) between 2010 and 2019 in the Surveillance, Epidemiology, and End Results (SEER) database. We used simple and multivariate Logistic regression analyses to identify independent risk factors for BM in MBC patients. Then simple and multivariate Cox regression analyses were employed to determine the independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS) in MBCBM patients. We established and validated three new nomograms based on these independent factors. RESULT: A total of 4187 MBC patients were included, with 191 (4.56%) having bone metastases at the time of diagnosis. The independent risk factors of BM in MBC patients included age, tumor size, marital status, T stage, and N stage. In MBCBM patients, independent prognostic factors for OS and CSS were both age, T stage, ER status, PR status, and surgery. The concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic curve (ROC), the calibration curve, and the decision curve analysis (DCA) confirmed that these three nomograms could accurately predict the diagnosis and prognosis of MBCBM patients with excellent discrimination and clinical utility superior to the TNM staging system. We then established two prognostic-based risk stratification systems and three visualized dynamic nomograms that could be applied in clinical practice. CONCLUSION: In conclusion, this study aimed to establish and validate an accurate novel nomogram to objectively predict the diagnosis and prognosis of MBCBM patients. On this basis, prognostic-based risk stratification systems and visualized dynamic nomograms were constructed to facilitate doctors and patients to quantify individual BM risk probability and survival probability to assist in personalized risk assessment and clinical decision-making. |
format | Online Article Text |
id | pubmed-9691876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96918762022-11-26 Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases Gao, Bing Ou, Xiao-lan Li, Mu-feng Wang, Meng-die Huang, Fei Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Bone metastases (BM) from malignant tumors could disrupt the balance between osteoclasts and osteoblasts and affect bone homeostasis. Malignant breast cancer (BC) is rare in male patients, and co-occurrence of BM is even rarer. Given its low incidence, there is limited research evaluating risk and prognosis. Despite the widespread application of nomograms to predict uncommon malignancies, no studies have constructed predictive models focusing on the diagnosis and prognosis of male breast cancer with bone metastases (MBCBM). METHODS: This study selected all male breast cancer patients (MBC) between 2010 and 2019 in the Surveillance, Epidemiology, and End Results (SEER) database. We used simple and multivariate Logistic regression analyses to identify independent risk factors for BM in MBC patients. Then simple and multivariate Cox regression analyses were employed to determine the independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS) in MBCBM patients. We established and validated three new nomograms based on these independent factors. RESULT: A total of 4187 MBC patients were included, with 191 (4.56%) having bone metastases at the time of diagnosis. The independent risk factors of BM in MBC patients included age, tumor size, marital status, T stage, and N stage. In MBCBM patients, independent prognostic factors for OS and CSS were both age, T stage, ER status, PR status, and surgery. The concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic curve (ROC), the calibration curve, and the decision curve analysis (DCA) confirmed that these three nomograms could accurately predict the diagnosis and prognosis of MBCBM patients with excellent discrimination and clinical utility superior to the TNM staging system. We then established two prognostic-based risk stratification systems and three visualized dynamic nomograms that could be applied in clinical practice. CONCLUSION: In conclusion, this study aimed to establish and validate an accurate novel nomogram to objectively predict the diagnosis and prognosis of MBCBM patients. On this basis, prognostic-based risk stratification systems and visualized dynamic nomograms were constructed to facilitate doctors and patients to quantify individual BM risk probability and survival probability to assist in personalized risk assessment and clinical decision-making. Frontiers Media S.A. 2022-11-11 /pmc/articles/PMC9691876/ /pubmed/36440188 http://dx.doi.org/10.3389/fendo.2022.1013338 Text en Copyright © 2022 Gao, Ou, Li, Wang and Huang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Gao, Bing Ou, Xiao-lan Li, Mu-feng Wang, Meng-die Huang, Fei Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases |
title | Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases |
title_full | Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases |
title_fullStr | Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases |
title_full_unstemmed | Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases |
title_short | Risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases |
title_sort | risk stratification system and visualized dynamic nomogram constructed for predicting diagnosis and prognosis in rare male breast cancer patients with bone metastases |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691876/ https://www.ncbi.nlm.nih.gov/pubmed/36440188 http://dx.doi.org/10.3389/fendo.2022.1013338 |
work_keys_str_mv | AT gaobing riskstratificationsystemandvisualizeddynamicnomogramconstructedforpredictingdiagnosisandprognosisinraremalebreastcancerpatientswithbonemetastases AT ouxiaolan riskstratificationsystemandvisualizeddynamicnomogramconstructedforpredictingdiagnosisandprognosisinraremalebreastcancerpatientswithbonemetastases AT limufeng riskstratificationsystemandvisualizeddynamicnomogramconstructedforpredictingdiagnosisandprognosisinraremalebreastcancerpatientswithbonemetastases AT wangmengdie riskstratificationsystemandvisualizeddynamicnomogramconstructedforpredictingdiagnosisandprognosisinraremalebreastcancerpatientswithbonemetastases AT huangfei riskstratificationsystemandvisualizeddynamicnomogramconstructedforpredictingdiagnosisandprognosisinraremalebreastcancerpatientswithbonemetastases |