Voelkel, Vinzenz and Draeger, Teresa and Groothuis-Oudshoorn, Catharina G. M. and de Munck, Linda and Hueting, Tom and Gerken, Michael and Klinkhammer-Schalke, Monika and Lavric, Miha and Siesling, Sabine (2019) Predicting the risk of locoregional recurrence after early breast cancer: an external validation of the Dutch INFLUENCE-nomogram with clinical cancer registry data from Germany. JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, 145 (7). pp. 1823-1833. ISSN 0171-5216, 1432-1335
Full text not available from this repository. (Request a copy)Abstract
PurposeFollow-up after breast cancer treatment aims for an early detection of locoregional breast cancer recurrences (LRR) to improve the patients' outcome. By estimating individual's 5-year recurrence-risks, the Dutch INFLUENCE-nomogram can assist health professionals and patients in developing personalized risk-based follow-up pathways. The objective of this study is to validate the prediction tool on non-Dutch patients.Material and methodsData for this external validation derive from a large clinical cancer registry in southern Germany, covering a population of 1.1million. Patients with curative resection of early-stage breast cancer, diagnosed between 2000 and 2012, were included in the analysis (n=6520). For each of them, an individual LRR-risk was estimated by the INFLUENCE-nomogram. Its predictive ability was tested by comparing estimated and observed LRR-probabilities using the Hosmer-Lemeshow goodness-of-fit test and C-statistics.ResultsIn the German validation-cohort, 2.8% of the patients developed an LRR within 5years after primary surgery (n=184). While the INFLUENCE-nomogram generally underestimates the actual LRR-risk of the German patients (p<0.001), its discriminative ability is comparable to the one observed in the original Dutch modeling-cohort (C-statistic German validation-cohort: 0.73, CI 0.69-0.77 vs. C-statistic Dutch modeling-cohort: 0.71, CI 0.69-0.73). Similar results were obtained in most of the subgroup analyses stratified by age, type of surgery and intrinsic biological subtypes.ConclusionThe outcomes of this external validation underline the generalizability of the INFLUENCE-nomogram beyond the Dutch population. The model performance could be enhanced in future by incorporating additional risk factors for LRR.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FOLLOW-UP; GUIDELINES; SURVIVAL; THERAPY; TIME; Mamma carcinoma; Personalized care; Follow-up; Tertiary prevention; Cancer registry; Health services research |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V. |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Apr 2020 07:03 |
| Last Modified: | 06 Apr 2020 07:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26786 |
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