Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
The 1st School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Oncologist. 2024 Aug 5;29(8):e976-e983. doi: 10.1093/oncolo/oyae164.
PREDICT is a web-based tool for forecasting breast cancer outcomes. PREDICT version 3.0 was recently released. This study aimed to validate this tool for a large population in mainland China and compare v3.0 with v2.2.
Women who underwent surgery for nonmetastatic primary invasive breast cancer between 2010 and 2020 from the First Affiliated Hospital of Wenzhou Medical University were selected. Predicted and observed 5-year overall survival (OS) for both v3.0 and v2.2 were compared. Discrimination was compared using receiver-operator curves and DeLong test. Calibration was evaluated using calibration plots and chi-squared test. A difference greater than 5% was deemed clinically relevant.
A total of 5424 patients were included, with median follow-up time of 58 months (IQR 38-89 months). Compared to v2.2, v3.0 did not show improved discriminatory accuracy for 5-year OS (AUC: 0.756 vs 0.771), same as ER-positive and ER-negative patients. However, calibration was significantly improved in v3.0, with predicted 5-year OS deviated from observed by -2.0% for the entire cohort, -2.9% for ER-positive and -0.0% for ER-negative patients, compared to -7.3%, -4.7% and -13.7% in v2.2. In v3.0, 5-year OS was underestimated by 9.0% for patients older than 75 years, and 5.8% for patients with micrometastases. Patients with distant metastases postdiagnosis was overestimated by 10.6%.
PREDICT v3.0 reliably predicts 5-year OS for the majority of Chinese patients with breast cancer. PREDICT v3.0 significantly improved the predictive accuracy for ER-negative groups. Furthermore, caution is advised when interpreting 5-year OS for patients aged over 70, those with micrometastases or metastases postdiagnosis.
PREDICT 是一款用于预测乳腺癌结局的网络工具。最近发布了 PREDICT 3.0 版本。本研究旨在验证该工具在中国内地大人群中的适用性，并比较 v3.0 与 v2.2 的差异。
从温州医科大学第一附属医院选择 2010 年至 2020 年间接受非转移性原发性浸润性乳腺癌手术的女性。比较 v3.0 和 v2.2 预测的和观察到的 5 年总生存（OS）。使用接收者操作特征曲线和 DeLong 检验比较判别能力。使用校准图和卡方检验评估校准。差异大于 5% 被认为具有临床意义。
共纳入 5424 例患者，中位随访时间为 58 个月（IQR 38-89 个月）。与 v2.2 相比，v3.0 并未显示出对 5 年 OS 的判别准确性的提高（AUC：0.756 比 0.771），在 ER 阳性和 ER 阴性患者中也如此。然而，v3.0 的校准得到了显著改善，与 v2.2 相比，整个队列的预测 5 年 OS 与观察值相差-2.0%，ER 阳性患者相差-2.9%，ER 阴性患者相差-0.0%，而 v2.2 分别相差-7.3%、-4.7%和-13.7%。在 v3.0 中，年龄大于 75 岁的患者 5 年 OS 被低估了 9.0%，微转移患者 5 年 OS 被低估了 5.8%。诊断后远处转移的患者被高估了 10.6%。
PREDICT v3.0 能可靠地预测中国大多数乳腺癌患者的 5 年 OS。PREDICT v3.0 显著提高了 ER 阴性组的预测准确性。此外，对于年龄大于 70 岁、微转移或诊断后转移的患者，解释 5 年 OS 时需谨慎。
