TY - JOUR
T1 - Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years
AU - Engelhardt, Ellen G.
AU - van den Broek, Alexandra J.
AU - Linn, Sabine C.
AU - Wishart, Gordon C.
AU - Rutgers, Emiel J. Th.
AU - van de Velde, Anthonie O.
AU - Smit, Vincent T. H. B. M.
AU - Voogd, Adri C.
AU - Siesling, Sabine
AU - Brinkhuis, Mariel
AU - Seynaeve, Caroline
AU - Westenend, Pieter J.
AU - Stiggelbout, Anne M.
AU - Tollenaar, Rob A. E. M.
AU - van Leeuwen, Flora E.
AU - van 't Veer, Laura J.
AU - Ravdin, Peter M.
AU - Pharaoh, Paul D. P.
AU - Schmidt, Marjanka K.
PY - 2017/6
Y1 - 2017/6
N2 - Importance: Online prognostication tools such as PREDICT and Adjuvant! are increasingly used in clinical practice by oncologists to inform patients and guide treatment decisions about adjuvant systemic therapy. However, their validity for young breast cancer patients is debated.Objective: To assess first, the prognostic accuracy of PREDICT's and Adjuvant! 10-year all-cause mortality, and second, its breast cancer-specific mortality estimates, in a large cohort of breast cancer patients diagnosedDesign: Hospital-based cohort.Setting: General and cancer hospitals.Participants: A consecutive series of 2710 patients without a prior history of cancer, diagnosed between 1990 and 2000 with unilateral stage I-III breast cancer agedMain outcome measures: Calibration and discriminatory accuracy, measured with C-statistics, of estimated 10-year all-cause and breast cancer-specific mortality.Results: Overall, PREDICT's calibration for all-cause mortality was good (predicted versus observed) mean(difference): -1.1% (95% CI: -3.2%-0.9%; P=0.28). PREDICT tended to under-estimate all-cause mortality in good prognosis subgroups (range mean(difference): -2.9% to -4.8%), overestimated all-cause mortality in poor prognosis subgroups (range mean(difference): 2.6%-9.4%) and underestimated survival in patientsConclusions: Although imprecise at the extremes, PREDICT's estimates of 10-year all-cause mortality seem reasonably sound for breast cancer patients
AB - Importance: Online prognostication tools such as PREDICT and Adjuvant! are increasingly used in clinical practice by oncologists to inform patients and guide treatment decisions about adjuvant systemic therapy. However, their validity for young breast cancer patients is debated.Objective: To assess first, the prognostic accuracy of PREDICT's and Adjuvant! 10-year all-cause mortality, and second, its breast cancer-specific mortality estimates, in a large cohort of breast cancer patients diagnosedDesign: Hospital-based cohort.Setting: General and cancer hospitals.Participants: A consecutive series of 2710 patients without a prior history of cancer, diagnosed between 1990 and 2000 with unilateral stage I-III breast cancer agedMain outcome measures: Calibration and discriminatory accuracy, measured with C-statistics, of estimated 10-year all-cause and breast cancer-specific mortality.Results: Overall, PREDICT's calibration for all-cause mortality was good (predicted versus observed) mean(difference): -1.1% (95% CI: -3.2%-0.9%; P=0.28). PREDICT tended to under-estimate all-cause mortality in good prognosis subgroups (range mean(difference): -2.9% to -4.8%), overestimated all-cause mortality in poor prognosis subgroups (range mean(difference): 2.6%-9.4%) and underestimated survival in patientsConclusions: Although imprecise at the extremes, PREDICT's estimates of 10-year all-cause mortality seem reasonably sound for breast cancer patients
KW - Breast cancer
KW - Young patients
KW - Prognostication tool
KW - PREDICT
KW - Adjuvant
KW - Prognostic accuracy
KW - MODEL PREDICT
KW - WOMEN
KW - AGE
KW - SURVIVAL
KW - IMPACT
KW - DEATH
KW - RISK
KW - HER2
KW - VALIDATION
KW - RECURRENCE
U2 - 10.1016/j.ejca.2017.03.015
DO - 10.1016/j.ejca.2017.03.015
M3 - Article
SN - 0959-8049
VL - 78
SP - 37
EP - 44
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -