Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years

Ellen G. Engelhardt; Alexandra J. van den Broek; Sabine C. Linn; Gordon C. Wishart; Emiel J. Th. Rutgers; Anthonie O. van de Velde; Vincent T. H. B. M. Smit; Adri C. Voogd; Sabine Siesling; Mariel Brinkhuis; Caroline Seynaeve; Pieter J. Westenend; Anne M. Stiggelbout; Rob A. E. M. Tollenaar; Flora E. van Leeuwen; Laura J. van 't Veer; Peter M. Ravdin; Paul D. P. Pharaoh; Marjanka K. Schmidt

doi:10.1016/j.ejca.2017.03.015

Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years

Ellen G. Engelhardt
, Alexandra J. van den Broek
, Sabine C. Linn
, Gordon C. Wishart
, Emiel J. Th. Rutgers
, Anthonie O. van de Velde
, Vincent T. H. B. M. Smit
, Adri C. Voogd
, Sabine Siesling
, Mariel Brinkhuis
, Caroline Seynaeve
, Pieter J. Westenend
, Anne M. Stiggelbout
, Rob A. E. M. Tollenaar
, Flora E. van Leeuwen
, Laura J. van 't Veer
, Peter M. Ravdin
, Paul D. P. Pharaoh
, Marjanka K. Schmidt^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 diagnosed

Design: 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 aged

Main 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 patients

Conclusions: Although imprecise at the extremes, PREDICT's estimates of 10-year all-cause mortality seem reasonably sound for breast cancer patients

Original language	English
Pages (from-to)	37-44
Number of pages	8
Journal	European Journal of Cancer
Volume	78
DOIs	https://doi.org/10.1016/j.ejca.2017.03.015
Publication status	Published - Jun 2017

Keywords

Breast cancer
Young patients
Prognostication tool
PREDICT
Adjuvant
Prognostic accuracy
MODEL PREDICT
WOMEN
AGE
SURVIVAL
IMPACT
DEATH
RISK
HER2
VALIDATION
RECURRENCE

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10.1016/j.ejca.2017.03.015

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Engelhardt, E. G., van den Broek, A. J., Linn, S. C., Wishart, G. C., Rutgers, E. J. T., van de Velde, A. O., Smit, V. T. H. B. M., Voogd, A. C., Siesling, S., Brinkhuis, M., Seynaeve, C., Westenend, P. J., Stiggelbout, A. M., Tollenaar, R. A. E. M., van Leeuwen, F. E., van 't Veer, L. J., Ravdin, P. M., Pharaoh, P. D. P., & Schmidt, M. K. (2017). Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years. European Journal of Cancer, 78, 37-44. https://doi.org/10.1016/j.ejca.2017.03.015

@article{61263d85aae348cf9cb7b882c3083286,

title = "Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years",

abstract = "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",

keywords = "Breast cancer, Young patients, Prognostication tool, PREDICT, Adjuvant, Prognostic accuracy, MODEL PREDICT, WOMEN, AGE, SURVIVAL, IMPACT, DEATH, RISK, HER2, VALIDATION, RECURRENCE",

author = "Engelhardt, \{Ellen G.\} and \{van den Broek\}, \{Alexandra J.\} and Linn, \{Sabine C.\} and Wishart, \{Gordon C.\} and Rutgers, \{Emiel J. Th.\} and \{van de Velde\}, \{Anthonie O.\} and Smit, \{Vincent T. H. B. M.\} and Voogd, \{Adri C.\} and Sabine Siesling and Mariel Brinkhuis and Caroline Seynaeve and Westenend, \{Pieter J.\} and Stiggelbout, \{Anne M.\} and Tollenaar, \{Rob A. E. M.\} and \{van Leeuwen\}, \{Flora E.\} and \{van 't Veer\}, \{Laura J.\} and Ravdin, \{Peter M.\} and Pharaoh, \{Paul D. P.\} and Schmidt, \{Marjanka K.\}",

year = "2017",

month = jun,

doi = "10.1016/j.ejca.2017.03.015",

language = "English",

volume = "78",

pages = "37--44",

journal = "European Journal of Cancer",

issn = "0959-8049",

publisher = "Elsevier Ltd",

}

Engelhardt, EG, van den Broek, AJ, Linn, SC, Wishart, GC, Rutgers, EJT, van de Velde, AO, Smit, VTHBM, Voogd, AC, Siesling, S, Brinkhuis, M, Seynaeve, C, Westenend, PJ, Stiggelbout, AM, Tollenaar, RAEM, van Leeuwen, FE, van 't Veer, LJ, Ravdin, PM, Pharaoh, PDP & Schmidt, MK 2017, 'Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years', European Journal of Cancer, vol. 78, pp. 37-44. https://doi.org/10.1016/j.ejca.2017.03.015

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 -

Accuracy of the online prognostication tools PREDICT and Adjuvant! for early-stage breast cancer patients younger than 50 years

Abstract

Keywords

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