Prognostic analysis and nomogram development of male breast cancer patients undergoing surgical resection:Based on SEER database        YU Jun-lin* ,YU You-lin.*Department of Oncology, Xiaogan Hospital Affiliated Wuhan University of Science and Technology, Xiaogan 432000, China
Corresponding author: YU You-lin，E-mail: yuyoulin2800@163.com
Abstract    Objective    To analyze the independent prognostic factors of male patients with infiltrating duct breast cancer undergoing surgical resection and develop a prognostic nomogram to further verify the accuracy of prediction. Methods    The clinicopathological characteristics and treatment status of 1662 male patients pathologically diagnosed as infiltrating duct breast cancer and undergoing surgical resection from 2010 to 2018 were collected from the SEER database. All patients were divided into training cohort (n=1246) and validation cohort (n=416) according to 3∶1 by random number grouping method. Independent prognostic factors were screened out to develop a nomogram prognostic model to predict 1-, 3-, and 5- years overall survival (OS) by univariate analysis and multivariate cox analysis. The predictive accuracy and discriminative ability of the nomogram were evaluated by the consistency index (c-index) and the calibration curve. Results    The five indicators including age, tumor diameter, clinical TNM, pathological grade, marital status are independent prognostic factors of OS (all P<0.05). A predictive nomogram model of 1, 3, and 5 years OS was developed by independent prognostic factors. The c-index of the nomogram in the training cohort is 0.730 (95%CI 0.694-0.766), which is higher than the American Joint Committee on Cancer(AJCC) clinical TNM staging system by 0.628 (95%CI：0.588-0.668); the c-index of the nomogram in the validation cohort  is 0.737 (95%CI 0.680-0.794), which is higher than the AJCC clinical TNM staging system by 0.584 (95%CI 0.516-0.652). The calibration curve shows that the predicted survival rate of the nomogram is in good agreement with the actual survival rate. Conclusion    A nomogram constructed based on independent prognostic factors including age, tumor diameter, clinical TNM, pathological grade, and marital status can more accurately predict the prognosis of male breast cancer patients undergoing surgical resection, which is beneficial to clinically individualized patient prognosis evaluation.