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. 2016 Dec 6;115(12):1471-1478.
doi: 10.1038/bjc.2016.359. Epub 2016 Nov 1.

The prognostic performance of Adjuvant! Online and Nottingham Prognostic Index in young breast cancer patients

Matteo Lambertini  1   2 , Ana Catarina Pinto  1 , Lieveke Ameye  3 , Lynn Jongen  4 , Lucia Del Mastro  5 , Fabio Puglisi  6   7 , Francesca Poggio  2 , Marta Bonotto  6   7 , Giuseppe Floris  8   9 , Kathleen Van Asten  4 , Hans Wildiers  4   10 , Patrick Neven  4   11 , Evandro de Azambuja  1 , Marianne Paesmans  3 , Hatem A Azim Jr  1
Affiliations

The prognostic performance of Adjuvant! Online and Nottingham Prognostic Index in young breast cancer patients

Matteo Lambertini et al. Br J Cancer. .

Abstract

Background: Limited data are available on the prognostic performance of Adjuvant! Online (AOL) and Nottingham Prognostic Index (NPI) in young breast cancer patients.

Methods: 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.

Results: 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.

Conclusions: 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.

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Conflict of interest statement

HAA reports employment at Innate Pharma at the end of this study; this employment is not related in any sort to the subject of the current study. All the remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Overall survival stratified by Nottingham Prognostic Index class in patients in the young cohort (A) and in the older cohort (B).
Figure 3
Figure 3
Receiver-operator characteristic (ROC) plot of Adjuvant! Online and Nottingham Prognostic Index to predict 10-year overall survival in patients in the young cohort (A) and in the older cohort (B); ROC plot of Adjuvant! Online and Nottingham Prognostic Index to predict 10-year disease-free survival in patients in the young cohort (C) and in the older cohort (D). AOL=Adjuvant! Online; NPI=Nottingham Prognostic Index.
See this image and copyright information in PMC

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