Abstract：
OBJECTIVE: The decision to perform surgery on breast cancer patients with lung-only metastasis is a subject of ongoing debate. Our investigation seeks to assess the survival rates following surgical intervention among individuals diagnosed with breast cancer experiencing isolated metastasis to the lungs. Additionally, we endeavor to devise a predictive nomogram aimed at forecasting the long-term survival.
METHODS: We analyzed patients diagnosed with primary lung metastases from breast cancer between 2010 and 2015, utilizing datasets obtained from the National Cancer Database (NCDB). We employed the Cox proportional hazards regression model and the Kaplan-Meier method to analyze survival data. Additionally, we constructed nomograms to forecast survival outcomes.
RESULTS: The study comprised 2403 patients, with 1058 (44.0%) undergoing breast-specific surgery and 1345 (56.0%) not receiving surgical treatment. The group that underwent surgical procedures exhibited a significantly enhanced overall survival (OS) compared to the non-surgery group (multivariate analysis: hazard ratio [HR] = 0.64; 95% confidence interval [CI], 0.54-0.75; p < 0.001). Surgical intervention consistently improved survival across nearly all patient subgroups. The research successfully established a predictive nomogram designed to calculate the likelihood of long-term survival, attaining a concordance index (C-index) of approximately 0.7 in both validation and training cohorts. By integrating multiple clinicopathological variables, the nomogram efficiently classified patients into categories reflecting different survival forecasts.
CONCLUSIONS: The findings of this investigation support the notion that surgical treatment can enhance the overall survival of patients with initial lung-only metastasis from breast cancer. The investigation further introduces a nomogram demonstrating reasonable accuracy in forecasting long-term survival of patients in this cohort.
METHODS: We analyzed patients diagnosed with primary lung metastases from breast cancer between 2010 and 2015, utilizing datasets obtained from the National Cancer Database (NCDB). We employed the Cox proportional hazards regression model and the Kaplan-Meier method to analyze survival data. Additionally, we constructed nomograms to forecast survival outcomes.
RESULTS: The study comprised 2403 patients, with 1058 (44.0%) undergoing breast-specific surgery and 1345 (56.0%) not receiving surgical treatment. The group that underwent surgical procedures exhibited a significantly enhanced overall survival (OS) compared to the non-surgery group (multivariate analysis: hazard ratio [HR] = 0.64; 95% confidence interval [CI], 0.54-0.75; p < 0.001). Surgical intervention consistently improved survival across nearly all patient subgroups. The research successfully established a predictive nomogram designed to calculate the likelihood of long-term survival, attaining a concordance index (C-index) of approximately 0.7 in both validation and training cohorts. By integrating multiple clinicopathological variables, the nomogram efficiently classified patients into categories reflecting different survival forecasts.
CONCLUSIONS: The findings of this investigation support the notion that surgical treatment can enhance the overall survival of patients with initial lung-only metastasis from breast cancer. The investigation further introduces a nomogram demonstrating reasonable accuracy in forecasting long-term survival of patients in this cohort.
摘要：
目的：对仅有肺转移的乳腺癌患者进行手术的决定是一个正在进行辩论的主题。我们的调查旨在评估被诊断为患有孤立性转移到肺部的乳腺癌患者手术干预后的生存率。此外,我们努力设计一个预测列线图，旨在预测长期生存。
方法：我们利用从国家癌症数据库（NCDB）获得的数据集，分析了2010年至2015年间诊断为乳腺癌原发性肺转移的患者。我们采用Cox比例风险回归模型和Kaplan-Meier方法分析生存数据。此外,我们构建了列线图来预测生存结局.
结果：该研究包括2403名患者，1058例(44.0%)接受乳房特异性手术，1345例(56.0%)未接受手术治疗。与非手术组相比，接受外科手术的组的总生存期（OS）显着提高（多变量分析：风险比[HR]=0.64；95％置信区间[CI]，0.54-0.75；p<0.001)。手术干预持续改善了几乎所有患者亚组的生存率。该研究成功建立了一个预测列线图，用于计算长期生存的可能性。在验证和训练队列中均达到约0.7的一致性指数(C指数)。通过整合多个临床病理变量，列线图有效地将患者分为反映不同生存预测的类别。
结论：这项研究的结果支持这样的观点，即手术治疗可以提高乳腺癌初始仅肺转移患者的总体生存率。该研究进一步引入了一个列线图，证明了该队列中患者长期生存率的预测准确性。
方法：我们利用从国家癌症数据库（NCDB）获得的数据集，分析了2010年至2015年间诊断为乳腺癌原发性肺转移的患者。我们采用Cox比例风险回归模型和Kaplan-Meier方法分析生存数据。此外,我们构建了列线图来预测生存结局.
结果：该研究包括2403名患者，1058例(44.0%)接受乳房特异性手术，1345例(56.0%)未接受手术治疗。与非手术组相比，接受外科手术的组的总生存期（OS）显着提高（多变量分析：风险比[HR]=0.64；95％置信区间[CI]，0.54-0.75；p<0.001)。手术干预持续改善了几乎所有患者亚组的生存率。该研究成功建立了一个预测列线图，用于计算长期生存的可能性。在验证和训练队列中均达到约0.7的一致性指数(C指数)。通过整合多个临床病理变量，列线图有效地将患者分为反映不同生存预测的类别。
结论：这项研究的结果支持这样的观点，即手术治疗可以提高乳腺癌初始仅肺转移患者的总体生存率。该研究进一步引入了一个列线图，证明了该队列中患者长期生存率的预测准确性。
