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The prognostic performance of Adjuvant! Online and Nottingham Prognostic Index in young breast cancer patients: an international multicentre hospital-based retrospective cohort study

Date

10 Oct 2016

Session

Poster display

Presenters

Matteo Lambertini

Citation

Annals of Oncology (2016) 27 (6): 43-67. 10.1093/annonc/mdw364

Authors

M. Lambertini1, A.C. Pinto2, L. Ameye3, L. Jongen4, L. Del Mastro5, F. Puglisi6, F. Poggio1, M. Bonotto7, G. Floris8, K. van Asten4, H. Wildiers4, P. Neven4, E. de Azambuja9, M. Paesmans3, H.A. Azim Jr.10

Author affiliations

  • 1 Department Of Medical Oncology, U.o. Oncologia Medica 2, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 - Genova/IT
  • 2 Department Of Medicine, Institute Jules Bordet, 1000 - Brussels/BE
  • 3 Data Centre, Institute Jules Bordet, 1000 - Brussels/BE
  • 4 Department Of Oncology, University Hospitals Leuven - Campus Gasthuisberg, Leuven/BE
  • 5 Medical Oncology, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, Genova/IT
  • 6 Department Of Medical And Biological Sciences, University of Udine, Udine/IT
  • 7 Department Of Medical Oncology, AOU Santa Maria della Misericordia, 33100 - Udine/IT
  • 8 Department Of Imaging And Pathology, University Hospitals Leuven - Campus Gasthuisberg, Leuven/BE
  • 9 Medical Oncology, Institute Jules Bordet, 1000 - Brussels/BE
  • 10 Medical Oncology, Institut Jules Bordet, 1000 - Brussels/BE
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Resources

Abstract 2679

Background

Adjuvant! Online (AOL) and Nottingham Prognostic Index (NPI) are prognostic tools that are widely used to aid treatment decision-making. Although performing globally well, their performance is unclear in populations other than those used in their validation studies and particularly in specific subgroups such as women ≤ 40 years. The present study aimed to evaluate for the first time the prognostic performance of AOL and NPI in young early breast cancer patients.

Methods

This is a multicentre hospital-based retrospective cohort study including young (≤ 40 years) and older (55-60 years) breast cancer patients treated from January 2000 until December 2004 at 4 large Belgian and Italian institutions. Predicted 10-year overall survival (OS) and disease-free survival (DFS) using AOL and 10-year OS using NPI were calculated for every patient. To assess calibration, the trimmed mean of the predicted 10-year outcomes was compared to the observed (Kaplan-Meier estimate at 10 years) 10-year rates by using one-sample t-test. Discriminatory accuracy was assessed by calculating the area under the receiver-operator characteristic curve and the corresponding 95% confidence intervals for 10-year predicted OS and DFS. Vital status was cross-checked with the national registries in Belgium and Italy.

Results

A total of 1,283 patients were included (376 in the young and 907 in the older cohorts, respectively). AOL accurately predicted 10-year OS (absolute difference: 0.66%; p = 0.37) in the young cohort, but overestimated 10-year DFS by 7.66% (p = 0.003). In the older cohort, AOL significantly underestimated both 10-year OS and DFS, by 7.20% (p 

Conclusions

In young breast cancer patients, AOL is a reliable tool in predicting OS at 10 years but not DFS, while the calibration performance of NPI is suboptimal. In patients aged 55-60 years, the role of AOL and NPI deserves further investigations.

Clinical trial identification

Not applicable

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.

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