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Gaceta médica de México
versão On-line ISSN 2696-1288versão impressa ISSN 0016-3813
Resumo
LUJAN, Mauricio et al. Concordance between 21-gene recurrence score assay and clinicopathological predictive models in early-breast cancer patients cared for at a cancer center in Colombia. Gac. Méd. Méx [online]. 2023, vol.159, n.1, pp.3-9. Epub 02-Maio-2023. ISSN 2696-1288. https://doi.org/10.24875/gmm.22000134.
Introduction:
The genomic-based 21-gene recurrence score assay (21-GRSA) allows to determine the usefulness of adjuvant chemotherapy in patients with luminal-type early breast cancer (LTEBC). Additional predictive models have also been developed, such as Magee equations (ME), the Predict model (PM), and the Tennessee nomogram score (TNS).
Objective:
To evaluate the concordance between 21-GRSA, ME, PM and TNS.
Methods:
Patients with unifocal LTEBC and 21-GRSA, ME, PM and TNS results were included. A subgroup analysis of women older than 50 years was carried out. Concordance between the models and 21-GRSA was evaluated using Cohen's kappa index (KI).
Results:
One-hundred and twenty-two women were included. Concordance between 21-GRSA and ME (KI = 0.35) and PM (KI = 0.24) was fair (p < 0.001). Concordance between 21-GRSA and TNS was inferior (KI = 0.16, p = 0.04). Eighty patients older than 50 years with sufficient data to calculate all three predictive models were included. Concordance was found between the low-risk classification on 21-GRSA and all three combined models in 36/37 patients (negative predictive value of 97.3%).
Conclusion:
21-GRSA can be omitted in women older than 50 years with LTEBC classified with low risk scores on all three predictive models.
Palavras-chave : Genomics; Breast neoplasms; Clinical decision rules.