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BRENDA-Score, a Highly Significant, Internally and Externally Validated Prognostic Marker for Metastatic Recurrence: Analysis of 10,449 Primary Breast Cancer Patients.
Wischnewsky, Manfred; Schwentner, Lukas; Diessner, Joachim Diessner; De Gregorio, Amelie; Joukhadar, Ralf; Davut, Dayan; Salmen, Jessica; Bekes, Inga; Kiesel, Matthias; Müller-Reiter, Max; Blettner, Maria; Wolters, Regine; Janni, Wolfgang; Kreienberg, Rolf; Wöckel, Achim; Ebner, Florian.
Afiliação
  • Wischnewsky M; FB Mathematik u. Informatik, Universität Bremen, Bibliothekar. 1, 28359 Bremen, Germany.
  • Schwentner L; Frauenklinik Universität Ulm, Prittwitzstr. 43, 89075 Ulm, Germany.
  • Diessner JD; Universitätsfrauenklinik Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany.
  • De Gregorio A; Frauenklinik Universität Ulm, Prittwitzstr. 43, 89075 Ulm, Germany.
  • Joukhadar R; Universitätsfrauenklinik Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany.
  • Davut D; Frauenklinik Universität Ulm, Prittwitzstr. 43, 89075 Ulm, Germany.
  • Salmen J; Universitätsfrauenklinik Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany.
  • Bekes I; Frauenklinik Universität Ulm, Prittwitzstr. 43, 89075 Ulm, Germany.
  • Kiesel M; Universitätsfrauenklinik Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany.
  • Müller-Reiter M; Universitätsfrauenklinik Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany.
  • Blettner M; Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin Mainz, 55131 Mainz, Germany.
  • Wolters R; FB Mathematik u. Informatik, Universität Bremen, Bibliothekar. 1, 28359 Bremen, Germany.
  • Janni W; Frauenklinik Universität Ulm, Prittwitzstr. 43, 89075 Ulm, Germany.
  • Kreienberg R; Frauenklinik Universität Ulm, Prittwitzstr. 43, 89075 Ulm, Germany.
  • Wöckel A; Universitätsfrauenklinik Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany.
  • Ebner F; Frauenklinik Universität Ulm, Prittwitzstr. 43, 89075 Ulm, Germany.
Cancers (Basel) ; 13(13)2021 Jun 22.
Article em En | MEDLINE | ID: mdl-34206581
Background Current research in breast cancer focuses on individualization of local and systemic therapies with adequate escalation or de-escalation strategies. As a result, about two-thirds of breast cancer patients can be cured, but up to one-third eventually develop metastatic disease, which is considered incurable with currently available treatment options. This underscores the importance to develop a metastatic recurrence score to escalate or de-escalate treatment strategies. Patients and methods Data from 10,499 patients were available from 17 clinical cancer registries (BRENDA-project [1]. In total, 8566 were used to develop the BRENDA-Index. This index was calculated from the regression coefficients of a Cox regression model for metastasis-free survival (MFS). Based on this index, patients were categorized into very high, high, intermediate, low, and very low risk groups forming the BRENDA-Score. Bootstrapping was used for internal validation and an independent dataset of 1883 patients for external validation. The predictive accuracy was checked by Harrell's c-index. In addition, the BRENDA-Score was analyzed as a marker for overall survival (OS) and compared to the Nottingham prognostic score (NPS). Results: Intrinsic subtypes, tumour size, grading, and nodal status were identified as statistically significant prognostic factors in the multivariate analysis. The five prognostic groups of the BRENDA-Score showed highly significant (p < 0.001) differences regarding MFS:low risk: hazard ratio (HR) = 2.4, 95%CI (1.7-3.3); intermediate risk: HR = 5.0, 95%CI.(3.6-6.9); high risk: HR = 10.3, 95%CI (7.4-14.3) and very high risk: HR = 18.1, 95%CI (13.2-24.9). The external validation showed congruent results. A multivariate Cox regression model for OS with BRENDA-Score and NPS as covariates showed that of these two scores only the BRENDA-Score is significant (BRENDA-Score p < 0.001; NPS p = 0.447). Therefore, the BRENDA-Score is also a good prognostic marker for OS. Conclusion: The BRENDA-Score is an internally and externally validated robust predictive tool for metastatic recurrence in breast cancer patients. It is based on routine parameters easily accessible in daily clinical care. In addition, the BRENDA-Score is a good prognostic marker for overall survival. Highlights: The BRENDA-Score is a highly significant predictive tool for metastatic recurrence of breast cancer patients. The BRENDA-Score is stable for at least the first five years after primary diagnosis, i.e., the sensitivities and specificities of this predicting system is rather similar to the NPI with AUCs between 0.76 and 0.81 the BRENDA-Score is a good prognostic marker for overall survival.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Cancers (Basel) Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Revista: Cancers (Basel) Ano de publicação: 2021 Tipo de documento: Article