Qualitative Assessment of the Progesterone Receptor and HER2 Improves the Nottingham Prognostic Index Up to 5 Years After Breast Cancer Diagnosis
| Autor: | Frédéric Amant, Karin Leunen, Robert Paridaens, Paula Murray, Olivier Brouckaert, V J Harvey, Gro Wiedswang, Bjørn Naume, Isabelle Vanden Bempt, Ann Smeets, Maria Drijkoningen, S Pintens, Patrick Neven, Ben Van Calster, Sabine Van Huffel, Ignace Vergote, Hans Wildiers, Vanya Van Belle, Marie Rose Christiaens, Philippe Moerman |
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| Přispěvatelé: | Other departments |
| Rok vydání: | 2010 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Time Factors Receptor ErbB-2 Estrogen receptor Breast Neoplasms Kaplan-Meier Estimate Risk Assessment Disease-Free Survival Breast cancer Belgium Predictive Value of Tests Risk Factors Internal medicine mental disorders Progesterone receptor Biomarkers Tumor medicine Health Status Indicators Humans In Situ Hybridization Aged Proportional Hazards Models Gynecology Norway Proportional hazards model business.industry Reproducibility of Results Cancer Middle Aged medicine.disease Immunohistochemistry Treatment Outcome Receptors Estrogen Cohort Nottingham Prognostic Index Female Breast disease Receptors Progesterone business New Zealand |
| Zdroj: | Journal of clinical oncology, 28(27), 4129-4134. American Society of Clinical Oncology |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2009.26.4200 |
| Popis: | Purpose To investigate whether the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) can improve the Nottingham Prognostic Index (NPI) in the classification of patients with primary operable breast cancer for disease-free survival (DFS). Patients and Methods The analysis is based on 1,927 patients with breast cancer treated between 2000 and 2005 at the University Hospitals, Leuven. We compared performances of NPI with and without ER, PR and/or HER2. Validation was done on two external data sets containing 862 and 2,805 patients from Oslo (Norway) and Auckland (New Zealand), respectively. Results In the Leuven cohort, median follow-up was 66 months, and 13.7% of patients experienced a breast cancer–related event. Positive staining for ER, PR, and HER2 was detected, respectively, in 86.9%, 75.5%, and 11.9% of patients. Based on multivariate Cox regression modeling, the improved NPI (iNPI) was derived as NPI − PR positivity + HER2 positivity. Validation results showed a risk group reclassification of 20% to 30% of patients when using iNPI with its optimal risk boundaries versus NPI, in a majority of patients to more appropriate risk groups. An additional 10% of patients were classified into the extreme risk groups, where clinical actions are less ambiguous. Survival curves of reclassified patients resembled more closely those for patients in the same iNPI group than those for patients in the same NPI group. Conclusion The addition of PR and HER2 to NPI increases its 5-year prognostic accuracy. The iNPI can be considered as a clinically useful tool for stratification of patients with breast cancer receiving standard of care. |
| Databáze: | OpenAIRE |
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