Objective::We aimed to identify critical clinical features to develop an accurate webbased
prediction model for estimating the overall survival (OS) of primary breast diffuse large Bcell
lymphoma (PB-DLBCL) adult patients.
Methods::We first included all PB-DLBCL cases with available covariates retrieved from the Surveillance,
Epidemiology, and End Results database. We sequentially performed univariate and
multivariate Cox regression approaches to identify the predictors independently associated with
prognosis, and all the predictors that passed these tests were then constructed to build a nomogram
for predicting 3-, 5-, and 10-year survival rates of patients. The C-index and the receiver operating
characteristic curve (ROC) were used to evaluate the prediction discrimination, and the calibration
curve was applied to estimate the calibration.
Results::A total of PB-DLBCL adult patients were included (median age was 69 with the interquartile
range [IQR] of 57-79 years), of which 466 (70%) were randomly allocated to the development
cohort, and the remaining cases were collected for validation. Using three identified independent
predictors (i.e., age, stage, and radiation), an accurate nomogram for predicting OS was
developed and validated. The C-indices of our nomogram were both relatively acceptable, with
0.74 (95% CI: 0.71-0.78) and 0.72 (95% CI: 0.70-0.75) for the development and validation cohorts,
respectively. The calibration curves also accurately predicted the prognosis of PB-DLBCL
in all cases. In addition, ROC curves showed our nomogram to possess superior predictive ability
compared to any single variable. To visually present this prediction model, a convenient webbased
tool was implemented based on our prognostic nomogram.
Conclusion::For patients with PB-DLBCL, a more convenient and accurate web-based prediction
model was developed and validated, which showed relatively good performances in both discrimination
and calibration during model development and validation. External evaluation and validation
are warranted by further independent studies.