Classical versus new prognostic factors for adjuvant treatment selection based on line software to estimate risk and benefit

Excerpt

The decision about whether to receive systemic adjuvant therapy for cancer depends on weighing the benefit (in terms of increased relapse-free or overall survival) against the cost and risk with such therapy. As the use of adjuvant therapy has been extended into node-negative breast cancer, the decisions have become less obvious because the benefit is smaller, particularly as compared with the risks associated with the therapy and nonbreast cancer mortality. Guidelines can be helpful in these situations, but a limitation of guidelines is that they usually are compendiums of expert opinion and provide little quantitative guidance. In addition, it can be difficult to state guidelines that can be patient specific when multiple parameters might be used in the decision (e.g. age, comorbidity state, actual number of nodes, tumor size, hormone receptor status, histologic grade, and additional pathologic laboratory evidence). …