Developing and Implementing the AJCC Prognostic System for Breast Cancer

摘要

In the past staging' systems provided a simple, easily understood ordering of patient' outcomes. For over thirty years breast cancer outcome prediction has been based on the TNM staging system. There are two problems with staging systems generally, and specifically with the TNM system: (1) they are not very accurate, (i.e., their predictions are not close to the true outcomes), and (2) their accuracy can not be substantially improved because additional predictive factors can not be included in the system without increasing the system's complexity to the point where it is not longer useful to the clinician. The objective of this research is to replace with current TNM stage system with a new prognostic system that is inherently more accurate than the current system and that can integrate new prognostic factors to further improve prognostic accuracy. There are three components to - accomplishing this objective, which are the goals of this research project: (1) the development of the prognostic model itself, (2) the creation of the prognostic system by training the model with breast cancer outcome data, and (3) the computer-based implementation of the system for clinicians and tumor registries (clinical decision support system).