The Age-Male-Albumin-Bilirubin-Platelets (aMAP) Risk Score Predicts Liver Metastasis Following Surgery for Breast Cancer in Chinese Population: A Retrospective Study

Abstract

Objective

The current study is conducted to investigate the potential prognostic value of the age-male-albumin-bilirubin-platelets (aMAP) score in breast cancer patients with liver metastasis after surgery.

Methods

This is a retrospective study of 178 breast cancer patients who developed liver metastasis after surgery. These patients were treated and followed up from 2000 to 2018 at our hospital. The aMAP risk score was estimated in accordance with the following formula: . The optimal cutoff value of the aMAP was evaluated via X-tile. Kaplan-Meier, Log-rank and Cox proportional hazards regression models were applied to determine the clinical influence of the aMAP score on the survival outcomes. The nomogram models were established by multivariate analyses. The calibration curves and decision curve analysis were applied to evaluate the estimated performance of the nomogram models.

Results

A total of 178 breast cancer patients were divided into low aMAP score group (<47.6) and high aMAP score group (≥47.6) via X-tile plots. The aMAP score was a potential prognostic factor in multivariate analysis. The median disease free survival (p=0.0013) and overall survival (p=0.0003) in low aMAP score group were longer than in high aMAP score group. The nomograms were constructed to predict the DFS with a C-index of 0.722 (95% CI, 0.673–0.771), and the OS with a C-index of 0.708 (95% CI, 0.661–0.755). The aMAP-based nomograms had good predictive performance.

Conclusion

The aMAP score is a potential prognostic factor in breast cancer with liver metastasis after surgery. The aMAP score-based nomograms were conducive to discriminate patients at high risks of liver metastasis and develop adjuvant treatment and prevention strategies.

Keywords:

• breast cancer
• aMAP score
• liver metastasis
• albumin
• prognosis

Institutional Review Board Statement

This retrospective single-center study was conducted in accordance with the amended Declaration of Helsinki and was approved by the ethics committee of Cancer Hospital Chinese Academy of Medical Sciences (No.82173328).

Data Sharing Statement

The material supporting the conclusion of this article has been included within the article.

Informed Consent Statement

The enrolled patients provided written informed consent for using their data in this retrospective study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflict of interest.

Additional information

Funding

This research was supported by grants from the National Nature Science Foundation of China (No.82173328), Hubei Province Postdoctoral Innovation Research Post Fund Project (No.0106540096), Open Fund for the Key Laboratory of Organ Transplantation of Ministry of Education and National Health Commission (No.2021QYKF03), Tongji Hospital Cultivation Project (No.2022B03), Chen Xiao-ping Foundation for the Development of Science and Technology of Hubei province, Youth Science Special Fund (No.CXPJJH123001-2308).