Estimation and external validation of a new prognostic model for predicting recurrence-free survival for early breast cancer patients in the UK.
Estimation and external validation of a new prognostic model for predicting recurrence-free survival for early breast cancer patients in the UK.
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DOI：
10.1038/sj.bjc.6605863
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发表时间：
2010-09-07
影响因子：
8.8
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中科院分区：
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我们的目的是估计和外部验证一种新的英国特有的预后模型，用于预测诊断为早期乳腺癌的女性首次复发事件（局部复发、转移复发或第二原发性乳腺癌）的长期风险。使用牛津丘吉尔医院 1844 名接受早期乳腺癌治疗的女性的预后特征和结果数据，基于参数回归的生存分析被用来估计无复发生存的预后模型。该模型纳入了已确定的预后因素，并使用独立数据进行了外部验证。其性能与诺丁汉预后指数（NPI）和佐剂进行了比较！在线的。阳性腋窝淋巴结的数量、肿瘤分级、肿瘤大小和患者年龄是复发的强有力的预测因素。雌激素受体（ER）阳性被证明可以提供中等的保护作用。该模型能够将患者分为不同的预后组，并在患者水平上进行良好的预测，平均 Brier 准确度评分=0.17（s.e=0.004），总体 C=0.745（95% CI，0.717-0.773）。当应用于第二个独立数据集时，其性能仅略有下降。与 NPI 相比，该模型能够更好地区分预后良好的女性，并且它没有高估 10 年无复发生存率到 Adjuvant 观察到的程度！在线的。这里估计的模型在个体患者和群体层面上都能很好地预测，并且似乎可以移植到在英国其他医院接受治疗的患者。其参数形式允许长期外推，这使其比目前使用的其他预测工具更具优势。简单的评分系统和参考表可以快速轻松地估计模型的 5 年、10 年和 15 年预测。该模型还可以作为交互式计算机程序下载。
We aimed to estimate and externally validate a new UK-specific prognostic model for predicting the long-term risk of a first recurrent event (local recurrence, metastatic recurrence, or second primary breast cancer) in women diagnosed with early breast cancer. Using data on the prognostic characteristics and outcomes of 1844 women treated for early breast cancer at the Churchill Hospital in Oxford, parametric regression-based survival analysis was used to estimate a prognostic model for recurrence-free survival. The model, which incorporated established prognostic factors, was externally validated using independent data. Its performance was compared with that of the Nottingham Prognostic Index (NPI) and Adjuvant! Online. The number of positive axillary lymph nodes, tumour grade, tumour size and patient age were strong predictors of recurrence. Oestrogen receptor (ER) positivity was shown to afford a moderate protective effect. The model was able to separate patients into distinct prognostic groups, and predicted well at the patient level, mean Brier Accuracy Score=0.17 (s.e.=0.004) and overall C=0.745 (95% CI, 0.717–0.773). Its performance diminished only slightly when applied to a second independent data set. When compared with the NPI, the model was able to better discriminate between women with excellent and good prognoses, and it did not overestimate 10-year recurrence-free survival to the extent observed for Adjuvant! Online. The model estimated here predicts well at both the individual patient and group levels, and appears transportable to patients treated at other UK hospitals. Its parametric form permits long-term extrapolation giving it an advantage over other prognostic tools currently in use. A simple point scoring system and reference table allow 5-, 10-, and 15-year predictions from the model to be quickly and easily estimated. The model is also available to download as an interactive computer program.
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影响因子：
3.7
作者：
COX, DR
通讯作者：
COX, DR
影响因子：
168.9
作者：
DELAROCHEFORDIERE, A;ASSELAIN, B;FOURQUET, A
通讯作者：
FOURQUET, A
影响因子：
45.3
作者：
Jonat, W;Kaufmann, M;Lisboa, B
通讯作者：
Lisboa, B
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H
影响因子：
8.8
作者：
通讯作者：
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