Validation of the online prediction tool PREDICT v. 2.0 in the Dutch breast cancer population

van Maaren, M.C.; van Steenbeek, C.D.; Pharoah, P.D.P.; Witteveen, A.; Sonke, G.S.; Strobbe, L.J.A.; Poortmans, P.M.P.; Siesling, S.

doi:10.1016/J.EJCA.2017.09.031

Title

Validation of the online prediction tool PREDICT v. 2.0 in the Dutch breast cancer population

Author

van Maaren, M.C.

van Steenbeek, C.D.

Pharoah, P.D.P.

Witteveen, A.

Sonke, G.S.

Strobbe, L.J.A.

Poortmans, P.M.P.

Siesling, S.

Abstract

Background: PREDICT version 2.0 is increasingly used to estimate prognosis in breast cancer. This study aimed to validate this tool in specific prognostic subgroups in the Netherlands. Methods: All operated women with non-metastatic primary invasive breast cancer, diagnosed in 2005, were selected from the nationwide Netherlands Cancer Registry (NCR). Predicted and observed 5- and 10-year overall survival (OS) were compared for the overall cohort, separated by oestrogen receptor (ER) status, and predefined subgroups. A > 5% difference was considered as clinically relevant. Discriminatory accuracy and goodness-of-fit were determined using the area under the receiver operating characteristic curve (AUC) and the Chi-squared-test. Results: We included 8834 patients. Discriminatory accuracy for 5-year OS was good (AUC 0.80). For ER-positive and ER-negative patients, AUCs were 0.79 and 0.75, respectively. Predicted 5-year OS differed from observed by -1.4% in the entire cohort, -0.7% in ER-positive and -4.9% in ER-negative patients. Five-year OS was accurately predicted in all subgroups. Discriminatory accuracy for 10-year OS was good (AUC 0.78). For ER-positive and ER-negative patients AUCs were 0.78 and 0.76, respectively. Predicted 10-year OS differed from observed by -1.0% in the entire cohort, -0.1% in ER-positive and -5.3 in ER-negative patients. Ten-year OS was overestimated (6.3%) in patients >= 75 years and underestimated (-13.%) in T3 tumours and patients treated with both endocrine therapy and chemotherapy (-6.6%). Conclusions: PREDICT predicts OS reliably in most Dutch breast cancer patients, although results for both 5-year and 10-year OS should be interpreted carefully in ER-negative patients. Furthermore, 10-year OS should be interpreted cautiously in patients >= 75 years, T3 tumours and in patients considering endocrine therapy and chemotherapy. (C) 2017 Elsevier Ltd. All rights reserved.

Language

English

Source (journal)

European journal of cancer. - Oxford, 1990, currens

Publication

Oxford : 2017

ISSN

0959-8049 [print]

1879-0852 [online]

DOI

10.1016/J.EJCA.2017.09.031

Volume/pages