Cambridge Breast Unit, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK.
Eur J Surg Oncol. 2011 May;37(5):411-7. doi: 10.1016/j.ejso.2011.02.001. Epub 2011 Mar 2.
Predict (www.predict.nhs.uk) is a prognostication and treatment benefit tool developed using UK cancer registry data. The aim of this study was to compare the 10-year survival estimates from Predict with observed 10-year outcome from a British Columbia dataset and to compare the estimates with those generated by Adjuvant! (www.adjuvantonline.com).
The analysis was based on data from 3140 patients with early invasive breast cancer diagnosed in British Columbia, Canada, from 1989-1993. Demographic, pathologic, staging and treatment data were used to predict 10-year overall survival (OS) and breast cancer specific survival (BCSS) using Adjuvant! and Predict models. Predicted outcomes from both models were then compared with observed outcomes.
Calibration of both models was excellent. The difference in total number of deaths estimated by Predict was 4.1 percent of observed compared to 0.7 percent for Adjuvant!. The total number of breast cancer specific deaths estimated by Predict was 3.4 percent of observed compared to 6.7 percent for Adjuvant! Both models also discriminate well with similar AUC for Predict and Adjuvant! respectively for both OS (0.709 vs 0.712) and BCSS (0.723 vs 0.727). Neither model performed well in women aged 20-35.
In summary Predict provided accurate overall and breast cancer specific survival estimates in the British Columbia dataset that are comparable with outcome estimates from Adjuvant! Both models appear well calibrated with similar model discrimination. This study provides further validation of Predict as an effective predictive tool following surgery for invasive breast cancer.
Predict（www.predict.nhs.uk）是一个预后和治疗效益工具，使用英国癌症登记数据开发。本研究的目的是将 Predict 的 10 年生存率估计与不列颠哥伦比亚省数据集的观察 10 年结果进行比较，并将这些估计与 Adjuvant！（www.adjuvantonline.com）生成的估计进行比较。
该分析基于加拿大不列颠哥伦比亚省 1989-1993 年间诊断为早期浸润性乳腺癌的 3140 名患者的数据。使用 Adjuvant！和 Predict 模型，利用人口统计学、病理学、分期和治疗数据来预测 10 年总生存率（OS）和乳腺癌特异性生存率（BCSS）。然后将这两种模型的预测结果与观察结果进行比较。
两种模型的校准都很好。Predict 估计的总死亡人数与观察结果相比差异为 4.1%，而 Adjuvant! 为 0.7%。Predict 估计的乳腺癌特异性死亡人数与观察结果相比差异为 3.4%，而 Adjuvant! 为 6.7%。对于 OS（0.709 对 0.712）和 BCSS（0.723 对 0.727），两种模型的 AUC 也都很好，Predict 和 Adjuvant! 分别具有相似的 AUC。两种模型在年龄为 20-35 岁的女性中表现不佳。
综上所述，Predict 在不列颠哥伦比亚省数据集提供了准确的总体和乳腺癌特异性生存率估计，与 Adjuvant！的结果估计相当。两种模型的校准都很好，具有相似的模型区分度。这项研究为 Predict 作为手术治疗浸润性乳腺癌的有效预测工具提供了进一步的验证。
