Department of Research, Netherlands Comprehensive Cancer Organisation, P.O. Box 19079, 3501 DB, Utrecht, The Netherlands.
Evidencio Medical Decision Support, Haaksbergen, The Netherlands.
Breast Cancer Res Treat. 2019 Dec;178(3):665-681. doi: 10.1007/s10549-019-05399-2. Epub 2019 Aug 30.
CancerMath predicts the expected benefit of adjuvant systemic therapy on overall (OS) and breast cancer-specific survival (BCSS). Here, CancerMath was validated in Dutch breast cancer patients.
All operated women diagnosed with stage I-III primary invasive breast cancer in 2005 were identified from the Netherlands Cancer Registry. Calibration was assessed by comparing 5- and 10-year predicted and observed OS/BCSS using χ tests. A difference > 3% was considered as clinically relevant. Discrimination was assessed by area under the receiver operating characteristic (AUC) curves.
Altogether, 8032 women were included. CancerMath underestimated 5- and 10-year OS by 2.2% and 1.9%, respectively. AUCs of 5- and 10-year OS were both 0.77. Divergence between predicted and observed OS was most pronounced in grade II, patients without positive nodes, tumours 1.01-2.00 cm, hormonal receptor positive disease and patients 60-69 years. CancerMath underestimated 5- and 10-year BCSS by 0.5% and 0.6%, respectively. AUCs were 0.78 and 0.73, respectively. No significant difference was found in any subgroup.
CancerMath predicts OS accurately for most patients with early breast cancer although outcomes should be interpreted with care in some subgroups. BCSS is predicted accurately in all subgroups. Therefore, CancerMath can reliably be used in (Dutch) clinical practice.
CancerMath 预测辅助全身治疗对总生存期（OS）和乳腺癌特异性生存期（BCSS）的预期获益。在此，在荷兰乳腺癌患者中验证了 CancerMath。
从荷兰癌症登记处确定了所有在 2005 年被诊断为 I-III 期原发性浸润性乳腺癌的手术女性患者。通过使用 χ 检验比较 5 年和 10 年预测的和观察的 OS/BCSS，评估校准。如果差异大于 3%，则认为具有临床意义。通过接受者操作特征（ROC）曲线下的面积来评估区分度。
总共纳入了 8032 名女性患者。CancerMath 分别低估了 5 年和 10 年的 OS 率 2.2%和 1.9%。5 年和 10 年 OS 的 AUC 均为 0.77。在 II 级、无阳性淋巴结的患者、肿瘤直径为 1.01-2.00cm、激素受体阳性疾病和 60-69 岁的患者中，预测的 OS 与观察的 OS 之间的差异最为明显。CancerMath 分别低估了 5 年和 10 年的 BCSS 率 0.5%和 0.6%。AUC 分别为 0.78 和 0.73。在任何亚组中均未发现显著差异。
CancerMath 能够准确预测大多数早期乳腺癌患者的 OS，但在某些亚组中，结果应谨慎解释。在所有亚组中，BCSS 都被准确预测。因此，CancerMath 可在（荷兰）临床实践中可靠使用。
