■乳腺癌(BC)是最常见的恶性肿瘤。患者的预后根据远处转移的位置而有所不同,胸膜是BC常见的转移部位。尽管如此,胸膜转移(PM)作为转移性BC(MBC)初始诊断时唯一的远处转移部位的患者的临床数据有限。
■回顾了2012年1月1日至2021年12月31日在山东省肿瘤医院住院的患者的病历,并选择符合研究条件的患者.采用Kaplan-Meier(KM)法进行生存分析。使用单变量和多变量Cox比例风险模型来识别预后因素。最后,基于这些选择的因素,构建并验证了列线图.
■总共,包括182例患者;58例(A组),81(B组),43例(C组)患者仅出现PM,仅肺转移(LM),和PM结合LM,分别。KM曲线显示三组之间的总生存期(OS)没有显着差异。然而,在远处转移(M-OS)后的生存率方面,差异有统计学意义:只有PM的患者表现出最好的预后,而PM合并LM的患者预后最差(中位M-OS:65.9、40.5和32.4个月,分别为;P=0.0067)。对于A组和C组的LM患者,恶性胸腔积液(MPE)患者的M-OS明显低于无MPE患者。单变量和多变量分析表明,原发癌部位,T级,N级,PM的位置,MPE是无其他远处转移的PM患者的独立预后因素。创建了包含这些变量的列线图预测模型。根据C指数(0.776),3-的AUC值,5-,和8年M-OS(分别为0.86、0.86和0.90),和校准曲线,预测和实际的M-OS符合很好。
■仅在首次诊断为MBC时患有PM的BC患者比仅患有LM或PM合并LM的患者预后更好。我们确定了这一子集患者中与M-OS相关的五个独立预后因素,建立了具有良好预测效果的列线图模型。
UNASSIGNED: Breast cancer (BC) is the most common malignant cancer. The prognosis of patients differs according to the location of distant metastasis, with pleura being a common metastatic site in BC. Nonetheless, clinical data of patients with pleural metastasis (PM) as the only distant metastatic site at initial diagnosis of metastatic BC (MBC) are limited.
UNASSIGNED: The medical records of patients who were hospitalized in Shandong Cancer Hospital between January 1, 2012 and December 31, 2021 were reviewed, and patients eligible for the study were selected. Survival analysis was conducted using Kaplan-Meier (KM) method. Univariate and multivariate Cox proportional-hazards models were used to identify prognostic factors. Finally, based on these selected factors, a nomogram was constructed and validated.
UNASSIGNED: In total, 182 patients were included; 58 (group A), 81 (group B), and 43 (group C) patients presented with only PM, only lung metastasis (LM), and PM combined with LM, respectively. The KM curves revealed no significant difference in overall survival (OS) among the three groups. However, in terms of survival after distant metastasis (M-OS), the difference was significant: patients with only PM exhibited the best prognosis, whereas those with PM combined with LM exhibited the worst prognosis (median M-OS: 65.9, 40.5, and 32.4 months, respectively; P = 0.0067). For patients with LM in groups A and C, those with malignant pleural effusion (MPE) exhibited significantly worse M-OS than those without MPE. Univariate and multivariate analyses indicated that primary cancer site, T stage, N stage, location of PM, and MPE were independent prognostic factors for patients with PM without other distant metastasis. A nomogram prediction model incorporating these variables was created. According to the C-index (0.776), the AUC values of the 3-, 5-, and 8-year M-OS (0.86, 0.86, and 0.90, respectively), and calibration curves, the predicted and actual M-OS were in good agreement.
UNASSIGNED: BC patients with PM only at the first diagnosis of MBC exhibited a better prognosis than those with LM only or PM combined with LM. We identified five independent prognostic factors associated with M-OS in this subset of patients, and a nomogram model with good predictive efficacy was established.