Lambertini Matteo, Pinto Ana Catarina, Ameye Lieveke, Jongen Lynn, Del Mastro Lucia, Puglisi Fabio, Poggio Francesca, Bonotto Marta, Floris Giuseppe, Van Asten Kathleen, Wildiers Hans, Neven Patrick, de Azambuja Evandro, Paesmans Marianne, Azim Hatem A
Department of Medicine, BrEAST Data Centre, Institut Jules Bordet, and l'Université Libre de Bruxelles (U.L.B.), Boulevard de Waterloo 121, 1000 Brussels, Belgium.
Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, 16132 Genova, Italy.
Br J Cancer. 2016 Dec 6;115(12):1471-1478. doi: 10.1038/bjc.2016.359. Epub 2016 Nov 1.
Limited data are available on the prognostic performance of Adjuvant! Online (AOL) and Nottingham Prognostic Index (NPI) in young breast cancer patients.
This multicentre hospital-based retrospective cohort study included young (⩽40 years) and older (55-60 years) breast cancer patients treated from January 2000 to December 2004 at four 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. Tools ability to predict outcomes (i.e., calibration) and their discriminatory accuracy was assessed.
The study included 1283 patients, 376 young and 907 older women. Adjuvant! Online accurately predicted 10-year OS (absolute difference: 0.7%; P=0.37) in young cohort, but overestimated 10-year DFS by 7.7% (P=0.003). In older cohort, AOL significantly underestimated both 10-year OS and DFS by 7.2% (P<0.001) and 3.2% (P=0.04), respectively. Nottingham Prognostic Index significantly underestimated 10-year OS in both young (8.5%; P<0.001) and older (4.0%; P<0.001) cohorts. Adjuvant! Online and NPI had comparable discriminatory accuracy.
In young breast cancer patients, AOL is a reliable tool in predicting OS at 10 years but not DFS, whereas the performance of NPI is sub-optimal.
关于辅助治疗在线系统（AOL）和诺丁汉预后指数（NPI）在年轻乳腺癌患者中的预后评估性能的数据有限。
这项基于多中心医院的回顾性队列研究纳入了2000年1月至2004年12月在比利时和意大利的四家大型机构接受治疗的年轻（≤40岁）和年长（55 - 60岁）乳腺癌患者。为每位患者计算使用AOL预测的10年总生存率（OS）和无病生存率（DFS）以及使用NPI预测的10年OS。评估了这些工具预测结果的能力（即校准）及其区分准确性。
该研究纳入了1283例患者，其中376例为年轻女性，907例为年长女性。辅助治疗在线系统在年轻队列中准确预测了10年OS（绝对差异：0.7%；P = 0.37），但高估了10年DFS 7.7%（P = 0.003）。在年长队列中，AOL分别显著低估了10年OS和DFS 7.2%（P < 0.001）和3.2%（P = 0.04）。诺丁汉预后指数在年轻（8.5%；P < 0.001）和年长（4.0%；P < 0.001）队列中均显著低估了10年OS。辅助治疗在线系统和NPI具有相当的区分准确性。
在年轻乳腺癌患者中，AOL是预测10年OS的可靠工具，但不是预测DFS的可靠工具，而NPI的性能欠佳。
