机构:[1]Guangdong Academy of Population Development, Guangzhou 510600, Guangdong Province, China[2]Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China[3]School of Nursing, Yale University, Orange, CT 06477, USA[4]School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR[5]Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang 550025, Guizhou Province, China[6]Army Medical University, Chongqing Municipality 400038, China[7]The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China深圳市中医院深圳医学信息中心[8]South China University of Technology, Guangzhou 510641, Guangdong Province, China[9]Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Background Resilience is important in cancer survivorship and has great potential to predict long-term quality of life (QoL) in breast cancer. The study was designed to develop a new prediction model to estimate pretest probability (PTP) of 1-year decreased QoL combing Resilience Index (RI) and conventional risk factors. Methods RI was extracted from 10-item Resilience Scale Specific to Cancer (RS-SC-10) based on the Principal Component Analysis (PCA). Patients were enrolled from Be Resilient to Breast Cancer (BRBC) and the prediction model was developed based on a sample of 506 consecutive patients and validated in an internal cohort (N1 = 314) and two external cohorts (N2 = 223 and N3 = 189). Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were utilized to estimate the incremental value of RI. Results RI improved prediction above conventional risk factors. AUC increased from 0.745 to 0.862 while IDI and NRI were 8.39% and 18.44% respectively (P < 0.0001 for all). Five predictors were included in the final model: RI, age, N stage, M stage, and baseline QoL. The new model demonstrated good calibration ability in the internal and external cohorts resulting in C-indexes of 0.862 (95%CI, 0.815-0.909), 0.828 (95%CI, 0.745-0.910), 0.880 (95%CI, 0.816-0.944), and 0.869 (95%CI, 0.796-0.941). Conclusion RI contributed to a more accurate estimation for PTP of 1-year decreased QoL above conventional risk factors and could help optimize decision making of treatment for breast cancer. Implications for cancer survivors A promising prognostic indicator of RI could improve QoL-related management in Chinese patients with breast cancer.
基金:
National Natural Science Foundation of China [71904033]; Young Elite Scientists Sponsorship Program by CACM [2021-QNRC2-B08]; Humanity and Social Science Youth Foundation of Ministry of Education of China [19YJCZH227]; Humanity and Social Science Foundation of Department of Education of Guangdong Province [2020WTSCX009]; Humanity and Social Science Foundation of Guangzhou [2021GZGJ57]; Guangdong Research Center for TCM Service and Industrial Development, Guangzhou University of Chinese Medicine [2022ZDA03]; Humanity and Social Science Foundation of Guangzhou University of Chinese Medicine [2020SKXK01, 2021SKYB07]
第一作者机构:[1]Guangdong Academy of Population Development, Guangzhou 510600, Guangdong Province, China
共同第一作者:
通讯作者:
推荐引用方式(GB/T 7714):
Liang Mu Zi,Tang Ying,Knobf M. Tish,et al.Resilience index improves prediction of 1-year decreased quality of life in breast cancer[J].JOURNAL OF CANCER SURVIVORSHIP.2023,17(3):759-768.doi:10.1007/s11764-022-01239-3.
APA:
Liang Mu Zi,Tang Ying,Knobf, M. Tish,Molassiotis, Alex,Peng, Chen...&Ye Zeng Jie.(2023).Resilience index improves prediction of 1-year decreased quality of life in breast cancer.JOURNAL OF CANCER SURVIVORSHIP,17,(3)
MLA:
Liang Mu Zi,et al."Resilience index improves prediction of 1-year decreased quality of life in breast cancer".JOURNAL OF CANCER SURVIVORSHIP 17..3(2023):759-768