Highlights
- •This study validates PREDICT version 2.0 in Dutch breast cancer patients.
- •PREDICT is a reliable prediction tool for Dutch breast cancer patients.
- •10-year overall survival must be interpreted with care in some subgroups.
- •Before used in clinical practice, prediction tools should be validated.
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.
Keywords
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Article info
Publication history
Published online: October 26, 2017
Accepted:
September 22,
2017
Received in revised form:
September 21,
2017
Received:
July 11,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
