TY - JOUR
T1 - External Validation of the Breast Cancer Surgery Risk Calculator (BCSRc)
T2 - A Predictive Model for Postoperative Complications
AU - Jonczyk, Michael M.
AU - Karamchandani, Manish
AU - Zaccardelli, Alessandra
AU - Bahadur, Aneesh
AU - Fisher, Carla Suzanne
AU - Czerniecki, Brian
AU - Margenthaler, Julie A.
AU - Persing, Sarah
AU - Homsy, Christopher
AU - Nardello, Salvatore
AU - O’Brien, Julie
AU - Losken, Albert
AU - Chatterjee, Abhishek
N1 - Publisher Copyright:
© 2023, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
PY - 2023/10
Y1 - 2023/10
N2 - Background: The breast cancer surgical risk calculator (BCSRc) is a prognostic tool that determines a breast cancer patient’s unique risk of acute complications following each possible surgical intervention. When used in the preoperative setting, it can help to stratify patients with an increased complication risk and enhance the patient-physician informed decision-making process. The objective of this study was to externally validate the four models used in the BCSRc on a large cohort of patients who underwent breast cancer surgery. Methods: The BCSRc was developed by using a retrospective cohort from the National Surgical Quality Improvement Program database from 2005 to 2018. Four models were built by using logistic regression methods to predict the following composite outcomes: overall, infectious, hematologic, and internal organ complications. This study obtained a new cohort of patients from the National Surgical Quality Improvement Program by utilizing participant user files from 2019 to 2020. The area under the curve, brier score, and Hosmer-Lemeshow goodness of fit test measured model performance, accuracy, and calibration, respectively. Results: A total of 192,095 patients met inclusion criteria in the development of the BCSRc, and the validation cohort included 60,144 women. The area under the curve during external validation for each model was approximately 0.70. Accuracy, or Brier scores, were all between 0.04 and 0.003. Model calibration using the Hosmer-Lemeshow statistic found all p-values > 0.05. All of these model coefficients will be updated on the web-based BCSRc platform: www.breastcalc.org . Conclusions: The BCSRc continues to show excellent external-validation measures. Collectively, this prognostic tool can enhance the decision-making process, help stratify patients with an increased complication risk, and improve expectant management.
AB - Background: The breast cancer surgical risk calculator (BCSRc) is a prognostic tool that determines a breast cancer patient’s unique risk of acute complications following each possible surgical intervention. When used in the preoperative setting, it can help to stratify patients with an increased complication risk and enhance the patient-physician informed decision-making process. The objective of this study was to externally validate the four models used in the BCSRc on a large cohort of patients who underwent breast cancer surgery. Methods: The BCSRc was developed by using a retrospective cohort from the National Surgical Quality Improvement Program database from 2005 to 2018. Four models were built by using logistic regression methods to predict the following composite outcomes: overall, infectious, hematologic, and internal organ complications. This study obtained a new cohort of patients from the National Surgical Quality Improvement Program by utilizing participant user files from 2019 to 2020. The area under the curve, brier score, and Hosmer-Lemeshow goodness of fit test measured model performance, accuracy, and calibration, respectively. Results: A total of 192,095 patients met inclusion criteria in the development of the BCSRc, and the validation cohort included 60,144 women. The area under the curve during external validation for each model was approximately 0.70. Accuracy, or Brier scores, were all between 0.04 and 0.003. Model calibration using the Hosmer-Lemeshow statistic found all p-values > 0.05. All of these model coefficients will be updated on the web-based BCSRc platform: www.breastcalc.org . Conclusions: The BCSRc continues to show excellent external-validation measures. Collectively, this prognostic tool can enhance the decision-making process, help stratify patients with an increased complication risk, and improve expectant management.
UR - http://www.scopus.com/inward/record.url?scp=85165017413&partnerID=8YFLogxK
U2 - 10.1245/s10434-023-13904-7
DO - 10.1245/s10434-023-13904-7
M3 - Article
C2 - 37458950
AN - SCOPUS:85165017413
SN - 1068-9265
VL - 30
SP - 6245
EP - 6253
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 10
ER -