Comparison of the Nottingham Prognostic Index and OncotypeDX© recurrence score in predicting outcome in estrogen receptor positive breast cancer.

Autor: Kerin EP; Discipline of Surgery, Lambe Institute for Translational Research, University of Galway, Galway, Ireland., Davey MG; Discipline of Surgery, Lambe Institute for Translational Research, University of Galway, Galway, Ireland. Electronic address: m.davey7@nuigalway.ie., McLaughlin RP; Department of Surgery, Galway University Hospitals, Galway, Ireland., Sweeney KJ; Department of Surgery, Galway University Hospitals, Galway, Ireland., Barry MK; Department of Surgery, Galway University Hospitals, Galway, Ireland., Malone CM; Department of Surgery, Galway University Hospitals, Galway, Ireland., Elwahab SA; Discipline of Surgery, Lambe Institute for Translational Research, University of Galway, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland., Lowery AJ; Discipline of Surgery, Lambe Institute for Translational Research, University of Galway, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland., Kerin MJ; Discipline of Surgery, Lambe Institute for Translational Research, University of Galway, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2022 Dec; Vol. 66, pp. 227-235. Date of Electronic Publication: 2022 Nov 03.
DOI: 10.1016/j.breast.2022.11.001
Abstrakt: Introduction: Traditionally, Nottingham prognostic index (NPI) informed prognosis in patients with estrogen receptor positive, human epidermal growth factor receptor-2 negative, node negative (ER+/HER2-/LN-) breast cancer. At present, OncotypeDX© Recurrence Score (RS) predicts prognosis and response to adjuvant chemotherapy (AC).
Aims: To compare NPI and RS for estimating prognosis in ER + breast cancer.
Methods: Consecutive patients with ER+/HER2-/LN- disease were included. Disease-free (DFS) and overall survival (OS) were determined using Kaplan-Meier and Cox regression analyses.
Results: 1471 patients met inclusion criteria. The mean follow-up was 110.7months. NPI was calculable for 1382 patients: 19.8% had NPI≤2.4 (291/1471), 33.0% had NPI 2.41-3.4 (486/1471), 30.0% had NPI 3.41-4.4 (441/1471), 10.9% had NPI 4.41-5.4 (160/1471), and 0.3% had NPI>5.4 (4/1471). In total, 329 patients underwent RS (mean RS: 18.7) and 82.1% had RS < 25 (270/329) and 17.9% had RS ≥ 25 (59/329). Using multivariable Cox regression analyses (n = 1382), NPI independently predicted DFS (Hazard ratio (HR): 1.357, 95% confidence interval (CI): 1.140-1.616, P < 0.001) and OS (HR: 1.003, 95% CI: 1.001-1.006, P = 0.024). When performing a focused analysis of those who underwent both NPI and RS (n = 329), neither biomarker predicted DFS or OS. Using Kaplan Meier analyses, NPI category predicted DFS (P = 0.008) and (P = 0.026) OS. Conversely, 21-gene RS group failed to predict DFS (P = 0.187) and OS (P = 0.296).
Conclusion: In our focused analysis, neither NPI nor RS predicted survival outcomes. However, in the entire series, NPI independently predicted both DFS and OS. On the 40th anniversary since its derivation, NPI continues to provide accurate prognostication in breast cancer, outperforming RS in the current study.
(Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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