Development and validation of a risk prediction model for tumor recurrence after breast-conserving surgery based on admission clinical data
10.7659/j.issn.1005-6947.240460
- VernacularTitle:基于入院临床资料的保乳术后乳腺癌复发风险预测模型构建与验证
- Author:
Qinxiang WU
1
;
Hengyi DING
1
;
Yufei LI
1
Author Information
1. 南阳医学高等专科学校第一附属医院 普通外科二病区,河南 南阳 473058
- Publication Type:Journal Article
- Keywords:
Breast Neoplasms;
Organ Sparing Treatments;
Recurrence;
Risk Factors;
Nomograms
- From:
Chinese Journal of General Surgery
2025;34(5):988-995
- CountryChina
- Language:Chinese
-
Abstract:
Background and Aims:Breast-conserving surgery,which balances tumor excision with preservation of breast tissue,has become a widely adopted surgical approach for breast cancer.However,postoperative tumor recurrence remains a major factor affecting patient prognosis.Accurate risk prediction tools are urgently needed to guide personalized treatment strategies.This study aimed to develop a risk prediction model for tumor recurrence after BCS based on admission clinical data and to evaluate its predictive performance to provide a scientific and practical tool for clinical decision-making.Methods:A total of 224 breast cancer patients who underwent breast-conserving surgery between May 2017 and May 2019 were enrolled.Postoperative recurrence was recorded during follow-up.Multivariate Logistic regression analysis was used to identify independent risk factors for recurrence and to construct a risk prediction model.The model's discriminative ability was assessed using the receiver operating characteristic(ROC)curve,and its calibration was evaluated using a calibration curve.Results:208 patients completed follow-up,ranging from 32 to 84 months,with a mean duration of(58.41±7.33)months.The recurrence rate was 17.79%.Multivariate Logistic regression analysis revealed that TNM stage Ⅲ(OR=2.029),tumor diameter≥4 cm(OR=1.782),≥4 lymph node metastases(OR=1.958),lymphovascular invasion(OR=1.984),and HER2 positivity(OR=1.774)were independent risk factors for recurrence(all P<0.05).The Logistic regression model was established as follows:Y=-12.788+0.707X?+0.578X?+0.672X?+0.685X?+0.573X?.The model yielded an area under the ROC curve(AUC)of 0.934(95%CI=0.891-0.963),with a sensitivity of 86.49%and specificity of 96.49%.The calibration curve demonstrated good agreement between predicted and observed outcomes(χ2=0.501,P=0.392).Conclusion:TNM stage Ⅲ,tumor diameter≥4 cm,≥4 lymph node metastases,lymphovascular invasion,and HER2 positivity are independent risk factors for tumor recurrence after breast-conserving surgery.The risk prediction model based on these factors demonstrates favorable discrimination and calibration,offering valuable guidance for postoperative risk assessment and clinical intervention.
