Establishment and verification of a nomogram to predict risk and prognostic factors of triple-negative breast cancer with organ metastasis based on the SEER cohort study

Abstract

Background:This study aims to identify the risk and prognostic factors of TNBC patients with organ metastasis, furthermore, establish and validate a nomogram to forecast the overall survival (OS). Methods:The Surveillance, Epidemiology, and End Results (SEER) database was used to collect the clinicopathological data of TNBC patients from 2010 to 2020. All the TNBC patients were divided into two groups: no organ metastasis cohort (n = 32154) and organ metastasis cohort (n = 1199) based on the presence or absence of organ metastasis, including liver, lung, bone, and brain). TNBC patients with organ metastasis were further randomly assigned into a training cohort and testing cohort in a 7:3 ratio. Univariate and multivariate Cox regression analyses were used to identify the independent prognostic factors. A nomogram was developed to predict the OS for TNBC patients with organ metastasis. The calibration curve, receiver operating characteristic (ROC) area under the curve (AUC), and the decision curve analysis (DCA) were used to estimate the accuracy and clinical effectiveness of the nomogram. Results: The median OS after organ metastasis was 12 months and 62 months in the group without organ metastasis. The 2-year survival rate in the liver metastasis cohort was 14.88%, the bone metastasis cohort was 22.17%, the lung metastasis cohort was 25.17% and the brain metastasis cohort was 12.08%. Multivariate Cox regression analysis revealed that age, T stage, surgery, and chemotherapy were independent factors affecting prognosis in the group with organ metastasis. The nomogram was established by the aforementioned variables. Conclusions:TNBC patients with organ metastasis had a worse prognosis. Age, T stage, surgery, and chemotherapy were independent prognostic factors of TNBC patients with organ metastasis. The nomogram was recommended for TNBC patients with organ metastasis and helped to make personalized clinical treatment plans.