The prognostic performance of Adjuvant! Online and Nottingham Prognostic Index in young breast cancer patients.
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.
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.
Matteo
M
Lambertini
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.
Ana Catarina
AC
Pinto
Data Centre, Institut Jules Bordet, and l'Université Libre de Bruxelles (U.L.B.), Boulevard de Waterloo 121, 1000 Brussels, Belgium.
Lieveke
L
Ameye
Department of Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, B-3000 Leuven, Belgium.
Lynn
L
Jongen
Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, 16132 Genova, Italy.
Lucia
L
Del Mastro
Department of Medical and Biological Sciences, University of Udine, Piazzale Santa Maria della Misericordia 15, 33010 Udine, Italy.|Department of Oncology, University Hospital of Udine, Piazzale Santa Maria della Misericordia 15, 33010 Udine, Italy.
Fabio
F
Puglisi
Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino-IST, Largo Rosanna Benzi 10, 16132 Genova, Italy.
Francesca
F
Poggio
Department of Medical and Biological Sciences, University of Udine, Piazzale Santa Maria della Misericordia 15, 33010 Udine, Italy.|Department of Oncology, University Hospital of Udine, Piazzale Santa Maria della Misericordia 15, 33010 Udine, Italy.
Marta
M
Bonotto
Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research, KU Leuven-University of Leuven, B-3000 Leuven, Belgium.|Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, B-3000 Leuven, Belgium.
Giuseppe
G
Floris
Department of Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, B-3000 Leuven, Belgium.
Kathleen
K
Van Asten
Department of Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, B-3000 Leuven, Belgium.|Department of General Medical Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, B-3000 Leuven, Belgium.
Hans
H
Wildiers
Department of Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, B-3000 Leuven, Belgium.|Department of Gynecology and Obstetrics, KU Leuven-University of Leuven, University Hospitals Leuven, B-3000 Leuven, Belgium.
Patrick
P
Neven
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.
Evandro
E
de Azambuja
Data Centre, Institut Jules Bordet, and l'Université Libre de Bruxelles (U.L.B.), Boulevard de Waterloo 121, 1000 Brussels, Belgium.
Marianne
M
Paesmans
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.
Hatem A
HA
Azim
D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis