A nomogram to predict adjuvant chemotherapy recommendation in breast cancer patients with intermediate recurrence score

摘要

Objective: The indication of adjuvant chemotherapy recommendation(ACR) in breast cancer patients with intermediate recurrence score(RS) is controversial. This study investigated the relationship between routine clinicopathological indicators and ACR, and established a nomogram for predicting the probability of ACR in this subset of patients.Methods: Data for a total of 504 consecutive patients with intermediate RS from January 2014 to December2016 were retrospectively reviewed. A nomogram was constructed using a multivariate logistic regression model based on data from a training set(378 cases) and validated in an independent validation set(126 cases). A Youdenderived cut-off value was assigned to the nomogram for accuracy evaluation.Results: The multivariate logistic regression analysis identified that age, histological grade, tumor size, lymph node(LN) status, molecular subtype, and RS were independent predictors of ACR. A nomogram based on these predictors performed well. The P value of the Hosmer-Lemeshow test for the prediction model was 0.286. The area under the curve(AUC) values were 0.905 [95% confidence interval(95% CI): 0.876–0.934] and 0.883(95%CI: 0.824–0.942) in the training and validation sets, respectively. The accuracies of the nomogram for ACR were84.4% in the training set and 82.1% in the validation set.Conclusions: We developed a nomogram to predict the probability of ACR in breast cancer patients with intermediate RS. This model may aid the individual risk assessment and guide treatment decisions in clinical practice.