Gretchen G Kimmick1, Brittny Major2, Jonathan Clapp3,4, Jeff Sloan2, Brandelyn Pitcher5,6, Karla Ballman7, Myra Barginear8, Rachel A Freedman9, Andrew Artz10, Heidi D Klepin11, Jacqueline M Lafky2, Judith Hopkins12, Eric Winer9, Clifford Hudis13, Hyman Muss14, Harvey Cohen5, Aminah Jatoi15, Arti Hurria16, Jeanne Mandelblatt17. 1. Duke Cancer Institute, Duke University Medical Center, Box 3204, Durham, NC, 29910, USA. gretchen.kimmick@duke.edu. 2. Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN, USA. 3. Department of Oncology, MedStar Georgetown University Medical Center, Washington, DC, USA. 4. Department of Biostatistics, Biomathematics and Bioinformatics, Georgetown University, Washington, DC, USA. 5. Duke Cancer Institute, Duke University Medical Center, Box 3204, Durham, NC, 29910, USA. 6. Alliance Statistics and Data Center, Duke University, Durham, NC, USA. 7. Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, New York, NY, USA. 8. Hofstra-North Shore LIJ School of Medicine, Northwell Health Cancer Institute, Lake Success, NY, USA. 9. Dana-Farber/Partners CancerCare, Boston, MA, USA. 10. University of Chicago Comprehensive Cancer Center, Chicago, IL, USA. 11. Wake Forest University School of Medicine, Winston-Salem, NC, USA. 12. Forsyth Regional Cancer Center, Winston-Salem, NC, USA. 13. American Society of Clinical Oncology, Alexandria, VA, USA. 14. UNC Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 15. Mayo Clinic, Rochester, MN, USA. 16. City of Hope, Duarte, CA, USA. 17. Department of Oncology and Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, MedStar Georgetown University Medical Center, Georgetown University, Washington, DC, USA.
Abstract
PURPOSE: Tools to estimate survival, such as ePrognosis ( http://eprognosis.ucsf.edu/carey2.php ), were developed for general, not cancer, populations. In older patients with breast cancer, accurate overall survival estimates would facilitate discussions about adjuvant therapies. METHODS: Secondary analyses were performed of data from two parallel breast cancer studies (CALGB/Alliance 49907/NCT000224102 and CALGB/Alliance 369901/NCT00068328). We included patients (n = 971) who were age 70 years and older with complete baseline quality of life data (194 from 49907; 777 from 369901). Estimated versus observed all-cause two-year mortality rates were compared. ePrognosis score was calculated based on age, sex, and daily function (derived from EORTC QLQ-C30). ePrognosis scores range from 0 to 10, with higher scores indicating worse prognosis based on mortality of community-dwelling elders and were categorized into three groups (0-2, 3-6, 7-10). Observed mortality rates were estimated using Kaplan-Meier methods. RESULTS: Patient mean age was 75.8 years (range 70-91) and 73% had stage I-IIA disease. Most patients were classified by ePrognosis as good prognosis (n = 562, 58% 0-2) and few (n = 18, 2% 7-10) poor prognosis. Two-year observed mortality rates were significantly lower than ePrognosis estimates for patients scoring 0-2 (2% vs 5%, p = 0.001) and 3-6 (8% vs 12%, p = 0.01). The same trend was seen with scores of 7-10 (23% vs 36%, p = 0.25). CONCLUSIONS: ePrognosis tool only modestly overestimates mortality rate in older breast cancer patients enrolled in two cooperative group studies. This tool, which estimates non-cancer mortality risk based on readily available clinical information may inform adjuvant therapy decisions but should be validated in non-clinical trial populations.
PURPOSE: Tools to estimate survival, such as ePrognosis ( http://eprognosis.ucsf.edu/carey2.php ), were developed for general, not cancer, populations. In older patients with breast cancer, accurate overall survival estimates would facilitate discussions about adjuvant therapies. METHODS: Secondary analyses were performed of data from two parallel breast cancer studies (CALGB/Alliance 49907/NCT000224102 and CALGB/Alliance 369901/NCT00068328). We included patients (n = 971) who were age 70 years and older with complete baseline quality of life data (194 from 49907; 777 from 369901). Estimated versus observed all-cause two-year mortality rates were compared. ePrognosis score was calculated based on age, sex, and daily function (derived from EORTC QLQ-C30). ePrognosis scores range from 0 to 10, with higher scores indicating worse prognosis based on mortality of community-dwelling elders and were categorized into three groups (0-2, 3-6, 7-10). Observed mortality rates were estimated using Kaplan-Meier methods. RESULTS: Patient mean age was 75.8 years (range 70-91) and 73% had stage I-IIA disease. Most patients were classified by ePrognosis as good prognosis (n = 562, 58% 0-2) and few (n = 18, 2% 7-10) poor prognosis. Two-year observed mortality rates were significantly lower than ePrognosis estimates for patients scoring 0-2 (2% vs 5%, p = 0.001) and 3-6 (8% vs 12%, p = 0.01). The same trend was seen with scores of 7-10 (23% vs 36%, p = 0.25). CONCLUSIONS: ePrognosis tool only modestly overestimates mortality rate in older breast cancer patients enrolled in two cooperative group studies. This tool, which estimates non-cancer mortality risk based on readily available clinical information may inform adjuvant therapy decisions but should be validated in non-clinical trial populations.
Entities:
Keywords:
Breast cancer; Elderly; Survival estimates; ePrognosis
Authors: Roger T Anderson; Tse-Chang Yang; Stephen A Matthews; Fabian Camacho; Teresa Kern; Heath B Mackley; Gretchen Kimmick; Christopher Louis; Eugene Lengerich; Nengliang Yao Journal: Health Serv Res Date: 2013-09-30 Impact factor: 3.402
Authors: Mara A Schonberg; Edward R Marcantonio; Long Ngo; Donglin Li; Rebecca A Silliman; Ellen P McCarthy Journal: J Clin Oncol Date: 2011-03-14 Impact factor: 44.544
Authors: Hyman B Muss; Donald A Berry; Constance T Cirrincione; Maria Theodoulou; Ann M Mauer; Alice B Kornblith; Ann H Partridge; Lynn G Dressler; Harvey J Cohen; Heather P Becker; Patricia A Kartcheske; Judith D Wheeler; Edith A Perez; Antonio C Wolff; Julie R Gralow; Harold J Burstein; Ahmad A Mahmood; Gustav Magrinat; Gutav Magrinat; Barbara A Parker; Ronald D Hart; Debjani Grenier; Larry Norton; Clifford A Hudis; Eric P Winer Journal: N Engl J Med Date: 2009-05-14 Impact factor: 91.245
Authors: Jeanne S Mandelblatt; Solomon B Makgoeng; Gheorghe Luta; Arti Hurria; Gretchen Kimmick; Claudine Isaacs; Michelle Tallarico; William T Barry; Brandy Pitcher; Eric P Winer; Clifford Hudis; Harvey J Cohen; Hyman B Muss Journal: J Geriatr Oncol Date: 2013-06-20 Impact factor: 3.599
Authors: Nienke A de Glas; Willemien van de Water; Ellen G Engelhardt; Esther Bastiaannet; Anton J M de Craen; Judith R Kroep; Hein Putter; Anne M Stiggelbout; Nir I Weijl; Cornelis J H van de Velde; Johanneke E A Portielje; Gerrit-Jan Liefers Journal: Lancet Oncol Date: 2014-05-13 Impact factor: 41.316
Authors: N A de Glas; E Bastiaannet; C C Engels; A J M de Craen; H Putter; C J H van de Velde; A Hurria; G J Liefers; J E A Portielje Journal: Br J Cancer Date: 2016-01-19 Impact factor: 7.640
Authors: Araba Adjei; Jan C Buckner; Elizabeth Cathcart-Rake; Hongbin Chen; Harvey J Cohen; Dyda Dao; Jo-Ellen De Luca; Josephine Feliciano; Rachel A Freedman; Richard M Goldberg; Judith Hopkins; Joleen Hubbard; Aminah Jatoi; Meghan Karuturi; Margaret Kemeny; Gretchen G Kimmick; Heidi D Klepin; Jessica L Krok-Schoen; Jacqueline M Lafky; Jennifer G Le-Rademacher; Daneng Li; Stuart M Lichtman; Ronald Maggiore; Jeanne Mandelblatt; Vicki A Morrison; Hyman B Muss; Michael O Ojelabi; Mina S Sedrak; Niveditha Subbiah; Virginia Sun; Susan Tuttle; Noam VanderWalde; Tanya Wildes; Melisa L Wong; Jennifer Woyach Journal: J Geriatr Oncol Date: 2019-06-11 Impact factor: 3.599
Authors: Rachel A Freedman; Nancy L Keating; Lydia E Pace; Joyce Lii; Ellen P McCarthy; Mara A Schonberg Journal: J Clin Oncol Date: 2017-07-27 Impact factor: 44.544
Authors: Hyman B Muss; Mei-Yin C Polley; Donald A Berry; Heshan Liu; Constance T Cirrincione; Maria Theodoulou; Ann M Mauer; Alice B Kornblith; Ann H Partridge; Lynn G Dressler; Harvey J Cohen; Patricia A Kartcheske; Edith A Perez; Antonio C Wolff; Julie R Gralow; Harold J Burstein; Ahmad A Mahmood; Linda M Sutton; Gustav Magrinat; Barbara A Parker; Ronald D Hart; Debjani Grenier; Arti Hurria; Aminah Jatoi; Larry Norton; Clifford A Hudis; Eric P Winer; Lisa Carey Journal: J Clin Oncol Date: 2019-07-24 Impact factor: 44.544
Authors: Marloes G M Derks; Cornelis J H van de Velde; Daniele Giardiello; Caroline Seynaeve; Hein Putter; Johan W R Nortier; Luc Y Dirix; Esther Bastiaannet; Johanneke E A Portielje; Gerrit-Jan Liefers Journal: Oncologist Date: 2019-01-03