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The prognosis of breast cancer brain metastasis (BCBM) patients was dismal and the prognoses varied by different prognostic factors. In the present study, we identified and built a robust prognostic model and developed reliable nomograms to estimate the individualized overall survival (OS) and breast cancer-specific survival (BCSS) of breast cancer patients with brain metastasis. A total of 789 newly diagnosed breast cancer brain metastasis (BCBM) patients were identified from the Surveillance Epidemiology and End Results (SEER) database and randomly divided into training (n=554) and testing (n=235) cohorts. The log-rank tests and the Cox proportional hazards model were applied to evaluate the prognostic effects of multiple clinicopathological variables on the survival of training cohorts. Significant prognostic factors were combined to build the nomograms that were evaluated using the index of concordance (C-index) and calibration plots for internal and external validations. Two nomograms shared the common prognostic indicators including age, tumor subtype, chemotherapy, surgery, and number of metastatic sites except the brain and median household income. In the training cohort, the Harrell's C-index for the constructed nomogram to predict OS and BCSS were 0.668 and 0.676, respectively. The calibration plots were consistent between the nomogram-predicted survival probability and actual survival probability. These results were reproducible when nomograms were applied to the testing cohort for external validation. In conclusion, nomograms that predicted 6-month, 1-, and 2-year OS and BCSS for newly diagnosed BCBM patients with satisfactory performance were constructed to help the physicians in evaluating the high risk of mortality in patients.
This article was published in the following journal.
Name: World neurosurgery
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