Research ArticleOriginal Article
Open Access

Development and validation of a nomogram to predict survival after neoadjuvant chemotherapy in elderly women with triple-negative invasive ductal breast cancer

A SEER population-based study

Ying Gao, Jinmiao Wang, Shoujun Wang, Weijie Tao, Ran Duan, Jie Hao and Ming Gao
Saudi Medical Journal January 2025, 46 (1) 43-51; DOI: https://doi.org/10.15537/smj.2025.46.1.20240341

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    - Patient selection flowchart.

  • Figure 2
    Figure 2

    - Nomogram for 1-, 3-, and 5-year disease-specific survival in elderly women with triple-negative invasive ductal breast cancer after neoadjuvant chemotherapy in the training cohort. TNM: tumor, node, and metastasis, NOS: not otherwise specified, CR: complete response, PR: partial response, NR: no response

  • Figure 3
    Figure 3

    - The receiver operating characteristic (ROC) curves. A) one-year survival (the area under the curve was 0.834). B) 3-year survival (the area under the curve was 0.796). C) 5-year survival (the area under the curve was 0.803) in the training cohort. AUC: area under the curve

  • Figure 4
    Figure 4

    - Calibration curves. A) one-year disease-specific survival in the training cohort. B) 3-year disease-specific survival in the training cohort. C) 5-year disease-specific survival in the training cohort. D) one-year disease-specific survival in the validation cohort. E) 3-year disease-specific survival in the validation cohort. F) 5-year disease-specific survival the validation cohort.

Tables

  • Table 1

    - Comparisons of clinicopathological characteristics and survival between the non-pathological complete response and pathological complete response groups of elderly women with triple-negative invasive ductal breast cancer after neoadjuvant chemotherapy.

    CharacteristicsNon-pathological complete response (n=285)Pathological complete response (n=97)P-values
    Age, years
    70-74153 (53.7)55 (56.7)0.585
    75-7990 (31.6)28 (28.9)
    80-8425 (8.8)11 (11.3)
    ≥8517 (6.0)3 (3.0)
    Race
    White197 (69.1)73 (75.3)0.751
    Black52 (18.2)14 (14.4)
    Asian or Pacific Islander30 (10.5)9 (9.3)
    American Indian/Alaska Native6 (2.1)1 (1.0)
    SEER summary stage
    Local involvement77 (27.0)45 (46.4)0.003
    Direct spread17 (6.0)5 (5.2)
    Regional lymph node involvement103 (36.1)32 (33.0)
    Direct spread and regional lymph node involvement58 (20.4)12 (12.4)
    Distant metastasis30 (10.5)3 (3.1)
    TNM
    I26 (9.1)15 (15.5)<0.001
    II114 (40.0)57 (58.8)
    III118 (41.4)23 (23.7)
    IV27 (9.4)2 (2.1)
    Tumor location
    Center16 (5.6)4 (4.1)0.481
    Axillary tail1 (0.4)0 (0.0)
    Lower outer quadrant25 (8.8)6 (6.2)
    Upper outer quadrant102 (35.8)33 (34.0)
    Lower inner quadrant13 (4.6)11 (11.3)
    Upper inner quadrant26 (9.1)8 (8.2)
    Overlapping region61 (21.4)23 (23.7)
    Unknown region41 (14.4)12 (12.4)
    Surgery, yes277 (97.2)97 (100)0.209
    Disease-specific survival, yes158 (55.4)86 (88.7)<0.001
    Overall survival, yes249 (87.4)86 (88.7)0.876

    Values are presented as numbers and percentages (%). Statistical tests were either Chi-square test (all categories with % ≥5) or Fisher-Freeman-Halton test (for multiple categorical variables that did not satisfy Chi-square test conditions). SEER: surveillance, epidemiology, and end results, TNM: tumor, node, and metastasis

    • Table 2

      - Comparisons of survival after propensity score matching based on clinicopathological characteristics between the non-pathological complete response and pathological complete response groups of elderly women with triple-negative invasive ductal breast cancer after neoadjuvant chemotherapy.

      CharacteristicsNon-pathological complete response (n=181)Pathological complete response (n=97)P-values
      Age, years
      70-74104 (57.5)55 (56.7)0.638
      75-7953 (29.3)28 (28.9)
      80-8414 (7.7)11 (11.3)
      ≥8510 (5.5)3 (3.0)
      Race
      White123 (68.0)73 (75.3)0.571
      Black31 (17.1)14 (14.4)
      Asian or Pacific Islander21 (11.6)9 (9.3)
      American Indian/Alaska Native6 (3.3)1 (1.0)
      SEER summary stage
      Local involvement77 (42.5)45 (46.4)0.988
      Direct spread10 (5.5)5 (5.2)
      Regional lymph node involvement64 (35.4)32 (33.0)
      Direct spread and regional lymph node involvement24 (13.3)12 (12.4)
      Distant metastasis6 (3.3)3 (3.1)
      TNM
      I24 (13.3)15 (15.5)0.961
      II107 (59.1)57 (58.8)
      III46 (25.4)23 (23.7)
      IV4 (2.2)2 (2.1)
      Tumor location
      Center8 (4.4)4 (4.1)0.643
      Axillary tail1 (0.5)0 (0.0)
      Lower outer quadrant20 (11.0)6 (6.2)
      Upper outer quadrant67 (37.0)33 (34.0)
      Lower inner quadrant11 (6.1)11 (11.3)
      Upper inner quadrant16 (8.8)8 (8.2)
      Overlapping region42 (23.2)23 (23.7)
      Unknown region16 (8.8)12 (12.4)
      Surgery, yes176 (97.2)97 (100)0.239
      Disease-specific survival, yes117 (64.6)86 (88.7)<0.001
      Overall survival, yes155 (85.6)86 (88.7)0.601

      Values are presented as numbers and percentages (%). Statistical tests were either Chi-square test (all categories with % ≥5) or Fisher-Freeman-Halton test (for multiple categorical variables that did not satisfy Chi-square test conditions). SEER: surveillance, epidemiology, and end results, TNM: tumor, node, and metastasis

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