Table 1.
Published predictive models for mortality in breast cancer patients.
| Reference | Patients | n | Time (years) | Variables | Clinical issues | Methodological issues | Validation |
|---|---|---|---|---|---|---|---|
| Jimenez-Lee et al.8 | BC stages 0–III | 389 | 5 | T, N and hormone receptors | Stage IV was excluded | The score for each variable was not justified and the definition of the risk groups was not justified | No |
| Chang et al.9 | BC stages 0–III and follow-up >1 year | 818 | 5 | Age, diagnostic methods, tumor grade, N, hormone receptors and chemotherapy | Assessed all-cause mortality, stage IV was excluded, diagnostic methods are not useful, the model was not explained | They used a logistic regression model with censored data and the events-per-variable was less than 10. | AUC = 0.894; p-value (H-L) = 0.945 |
| Fan et al.10 | Invasive BC with mastectomy | 1016 | 2 and 5 | Age, T, N, M and estrogen receptors | Assessed all-cause mortality, a specific population and the model is laborious | No comment | C-statistic = 0.80; Calibration plot |
| Faneyte et al.11 | BC without distant metastasis, <54 years, ≥4 positive lymph nodes, no previous other malignancies, treated with surgery and adjuvant therapy | 739 | 2 | Grade, estrogen receptors and N | Assessed all-cause mortality, a very specific population, the follow-up was very short and the model was not explained | They used a logistic regression model with censored data and it was not internally validated | No |
| Fontein et al.12 | Postmenopausal, endocrine-sensitive and early BC | 2602 | 5 | Age, hormone receptors, grade, T, N, HER2, treatment and locoregional recurrence | Assessed all-cause mortality, a very specific population, early BC was not defined, the model is laborious to use and the web tool does not work* | Internal validation was not assessed with bootstrapping | C-index = 0.70–0.79; HSF = 0.995 |
| The Nottingham Prognostic Index13–15. | Invasive primary operable BC with no other malignancies | 387 | 5 | T, N and grade | Assessed all-cause mortality and a specific population | The choice of cut-points was not explained, the risk groups changed in each publication and no bootstrapping | Graphically |
AUC, area under the ROC curve; BC, breast cancer; HER2, human epidermal growth factor receptor 2; HSF, heuristic shrinkage factor; H-L, Hosmer-Lemeshow test. *Tested in October 2016.