Long-term outcome prediction by clinicopathological risk classification algorithms in node-negative breast cancer--comparison between Adjuvant!, St Gallen, and a novel risk algorithm used in the prospective randomized Node-Negative-Breast Cancer-3 (NNBC-3) trial.
Details
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State: Public
Version: Final published version
State: Public
Version: Final published version
Serval ID
serval:BIB_32BB40430602
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long-term outcome prediction by clinicopathological risk classification algorithms in node-negative breast cancer--comparison between Adjuvant!, St Gallen, and a novel risk algorithm used in the prospective randomized Node-Negative-Breast Cancer-3 (NNBC-3) trial.
Journal
Annals of oncology : official journal of the European Society for Medical Oncology
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
02/2009
Peer-reviewed
Oui
Volume
20
Number
2
Pages
258-264
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Randomized Controlled Trial
Publication Status: ppublish
Publication Status: ppublish
Abstract
Defining risk categories in breast cancer is of considerable clinical significance. We have developed a novel risk classification algorithm and compared its prognostic utility to the Web-based tool Adjuvant! and to the St Gallen risk classification.
After a median follow-up of 10 years, we retrospectively analyzed 410 consecutive node-negative breast cancer patients who had not received adjuvant systemic therapy. High risk was defined by any of the following criteria: (i) age <35 years, (ii) grade 3, (iii) human epithelial growth factor receptor-2 positivity, (iv) vascular invasion, (v) progesterone receptor negativity, (vi) grade 2 tumors >2 cm. All patients were also characterized using Adjuvant! and the St Gallen 2007 risk categories. We analyzed disease-free survival (DFS) and overall survival (OS).
The Node-Negative-Breast Cancer-3 (NNBC-3) algorithm enlarged the low-risk group to 37% as compared with Adjuvant! (17%) and St Gallen (18%), respectively. In multivariate analysis, both Adjuvant! [P = 0.027, hazard ratio (HR) 3.81, 96% confidence interval (CI) 1.16-12.47] and the NNBC-3 risk classification (P = 0.049, HR 1.95, 95% CI 1.00-3.81) significantly predicted OS, but only the NNBC-3 algorithm retained its prognostic significance in multivariate analysis for DFS (P < 0.0005).
The novel NNBC-3 risk algorithm is the only clinicopathological risk classification algorithm significantly predicting DFS as well as OS.
After a median follow-up of 10 years, we retrospectively analyzed 410 consecutive node-negative breast cancer patients who had not received adjuvant systemic therapy. High risk was defined by any of the following criteria: (i) age <35 years, (ii) grade 3, (iii) human epithelial growth factor receptor-2 positivity, (iv) vascular invasion, (v) progesterone receptor negativity, (vi) grade 2 tumors >2 cm. All patients were also characterized using Adjuvant! and the St Gallen 2007 risk categories. We analyzed disease-free survival (DFS) and overall survival (OS).
The Node-Negative-Breast Cancer-3 (NNBC-3) algorithm enlarged the low-risk group to 37% as compared with Adjuvant! (17%) and St Gallen (18%), respectively. In multivariate analysis, both Adjuvant! [P = 0.027, hazard ratio (HR) 3.81, 96% confidence interval (CI) 1.16-12.47] and the NNBC-3 risk classification (P = 0.049, HR 1.95, 95% CI 1.00-3.81) significantly predicted OS, but only the NNBC-3 algorithm retained its prognostic significance in multivariate analysis for DFS (P < 0.0005).
The novel NNBC-3 risk algorithm is the only clinicopathological risk classification algorithm significantly predicting DFS as well as OS.
Keywords
Adult, Aged, Aged, 80 and over, Algorithms, Breast Neoplasms/genetics, Breast Neoplasms/pathology, Breast Neoplasms/radiotherapy, Breast Neoplasms/surgery, Disease-Free Survival, Female, Follow-Up Studies, Genes, erbB-2, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Longitudinal Studies, Middle Aged, Multivariate Analysis, Neoplasm Staging, Neovascularization, Pathologic, Predictive Value of Tests, Prognosis, Prospective Studies, Receptors, Progesterone/analysis, Regression Analysis, Retrospective Studies, Risk Assessment, Sensitivity and Specificity, Survival Analysis, Time Factors, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
13/10/2008 11:41
Last modification date
20/08/2019 14:18