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

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

*Corresponding author for this work

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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.

Original languageEnglish
Pages (from-to)364-372
Number of pages9
JournalEuropean journal of cancer
Volume86
DOIs
Publication statusPublished - 1 Nov 2017

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Breast Neoplasms
Survival
Population
Area Under Curve
Netherlands
Drug Therapy
Neoplasms
ROC Curve
Estrogen Receptors
Registries
Therapeutics

Keywords

  • Breast cancer
  • Overall survival
  • Population-based study
  • PREDICT
  • Prediction model
  • Validation

Cite this

van Maaren, M. C. ; van Steenbeek, C. D. ; Pharoah, P. D.P. ; Witteveen, A. ; Sonke, Gabe S. ; Strobbe, L.J.A. ; Poortmans, P.M.P. ; Siesling, S. / Validation of the online prediction tool PREDICT v. 2.0 in the Dutch breast cancer population. In: European journal of cancer. 2017 ; Vol. 86. pp. 364-372.
@article{25a7c5176e1546868e8fd37079626e17,
title = "Validation of the online prediction tool PREDICT v. 2.0 in the Dutch breast cancer population",
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 = "Breast cancer, Overall survival, Population-based study, PREDICT, Prediction model, Validation",
author = "{van Maaren}, {M. C.} and {van Steenbeek}, {C. D.} and Pharoah, {P. D.P.} and A. Witteveen and Sonke, {Gabe S.} and L.J.A. Strobbe and P.M.P. Poortmans and S. Siesling",
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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, Gabe S.; Strobbe, L.J.A.; Poortmans, P.M.P.; Siesling, S.

In: European journal of cancer, Vol. 86, 01.11.2017, p. 364-372.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Validation of the online prediction tool PREDICT v. 2.0 in the Dutch breast cancer population

AU - van Maaren, M. C.

AU - van Steenbeek, C. D.

AU - Pharoah, P. D.P.

AU - Witteveen, A.

AU - Sonke, Gabe S.

AU - Strobbe, L.J.A.

AU - Poortmans, P.M.P.

AU - Siesling, S.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - 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.

AB - 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.

KW - Breast cancer

KW - Overall survival

KW - Population-based study

KW - PREDICT

KW - Prediction model

KW - Validation

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U2 - 10.1016/j.ejca.2017.09.031

DO - 10.1016/j.ejca.2017.09.031

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C2 - 29100191

AN - SCOPUS:85032294443

VL - 86

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JO - European journal of cancer

JF - European journal of cancer

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