ArticleBritish journal of cancer2009
An investigation into the performance of the Adjuvant! Online prognostic programme in early breast cancer for a cohort of patients in the United Kingdom.
Article in British journal of cancer, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Communicating prognosis to women with early breast cancer - overview of prediction tools and the development and pilot testing of a decision aid.BMC health services research · 2019Pooled it
- Prognostic models for breast cancer: a systematic review.BMC cancer · 2019Pooled it
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- Validation of the postoperative prognostication tool PREDICT version 2.2 and 3.0 using data from the National cancer center hospital in Japan.Breast cancer (Tokyo, Japan) · 2026Article
- Identification of Patients with Early HR+ HER2- Breast Cancer at High Risk of Recurrence.Geburtshilfe und Frauenheilkunde · 2024Article
- Validation of PREDICT Version 2.2 in a Retrospective Cohort of Indian Women With Operable Breast Cancer.JCO global oncology · 2023Article
- A comparative analysis of recurrence risk predictions in ER+/HER2- early breast cancer using NHS Nottingham Prognostic Index, PREDICT, and CanAssist Breast.Breast cancer research and treatment · 2022Article
- Development of a Prognostic App (iCanPredict) to Predict Survival for Chinese Women With Breast Cancer: Retrospective Study.Journal of medical Internet research · 2022Article
- Advancement of prognostic models in breast cancer: a narrative review.Gland surgery · 2021Review
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- Multidimensional Machine Learning Personalized Prognostic Model in an Early Invasive Breast Cancer Population-Based Cohort in China: Algorithm Validation Study.JMIR medical informatics · 2020Article
- Review
- A Comprehensive Model for Predicting Recurrence and Survival in Cases of Chinese Postoperative Invasive Breast CancerAsian Pacific journal of cancer prevention : APJCP · 2017Article
- Are online prediction tools a valid alternative to genomic profiling in the context of systemic treatment of ER-positive breast cancer?Cellular & molecular biology letters · 2017Review
- The prognostic performance of Adjuvant! Online and Nottingham Prognostic Index in young breast cancer patients.British journal of cancer · 2016Article
- Article
- Prognostic models in male breast cancer.Breast cancer research and treatment · 2016Article
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- Internet tools to enhance breast cancer care.NPJ breast cancer · 2016Article
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4 authors.
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Abstract
backgroundAdjuvant! Online is an internet-based computer programme providing 10-year prognosis predictions for early breast cancer patients. It was developed in the United States, has been successfully validated in Canada, and is used in the United Kingdom and elsewhere. This study investigates the performance of Adjuvant! in a cohort of patients from the United Kingdom.
methodsData on the prognostic factors and management of 1065 women with early breast cancer diagnosed consecutively at the Churchill Hospital in Oxford between 1986 and 1996 were entered into Adjuvant! to generate predictions of overall survival (OS), breast cancer-specific survival (BCSS), and event-free survival (EFS) at 10 years. Such predictions were compared with the observed 10-year outcomes of these patients.
resultsFor the whole cohort, Adjuvant! significantly overestimated OS (by 5.54%, P<0.001), BCSS (by 4.53%, P<0.001), and EFS (by 3.51%, P=0.001). For OS and BCSS, overestimation persisted across most demographic, pathologic, and treatment subgroups investigated. Differences between Adjuvant! predicted and observed EFS appeared smaller, and were significant for far fewer subgroups, only 5 out of the 28. The likely explanation for such discordance is that US breast cancer mortality rates (upon which Adjuvant! is based) appear to be systematically lower than breast cancer mortality rates in the United Kingdom. Differences in survival after recurrence would seem to be one contributory factor, with data suggesting that prognosis after relapse appears poorer in the United Kingdom. This may reflect the fact that new and more effective cancer drugs are often only approved for use in the United Kingdom many years after their adoption in the United States.
conclusionThe use of Adjuvant! by clinicians within the UK National Health Service is increasing, under the assumption that the programme is transferrable to the United Kingdom. At least for women treated for breast cancer at the Churchill Hospital in Oxford, however, Adjuvant!'s predictions were on the whole overoptimistic. If the findings reported here could be shown to be generalisable to other areas of the United Kingdom, then thought should perhaps be given to the development of a UK-specific version of the programme.
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