{"doi":"10.1002/cncr.35163","title":"Validation of the RSClin risk calculator in the National Cancer Data Base","abstract":"BACKGROUND: Guidelines recommend the use of genomic assays such as OncotypeDx to aid in decisions regarding the use of chemotherapy for hormone receptor-positive, HER2-negative (HR+/HER2-) breast cancer. The RSClin prognostic tool integrates OncotypeDx and clinicopathologic features to predict distant recurrence and chemotherapy benefit, but further validation is needed before broad clinical adoption. METHODS: This study included patients from the National Cancer Data Base (NCDB) who were diagnosed with stage I-III HR+/HER2- breast cancer from 2010 to 2020 and received adjuvant endocrine therapy with or without chemotherapy. RSClin-predicted chemotherapy benefit was stratified into low (<3% reduction in distant recurrence), intermediate (3%-5%), and high (>5%). Cox models were used to model mortality adjusted for age, comorbidity index, insurance, and race/ethnicity. RESULTS: A total of 285,441 patients were identified for inclusion from the NCDB, with an average age of 60 years and a median follow-up of 58 months. Chemotherapy was associated with improved overall survival only for those predicted to have intermediate (adjusted hazard ratio [aHR], 0.68; 95% confidence interval [CI], 0.60-0.79) and high benefit per RSClin (aHR, 0.66; 95% CI, 0.61-0.72). Consistent benefit was seen in the subset with a low OncotypeDx score (<26) and intermediate (aHR, 0.66; 95% CI, 0.53-0.82) or high (aHR, 0.71; 95% CI, 0.58-0.86) RSClin-predicted benefit. No survival benefit with chemotherapy was seen in patients with a high OncotypeDx score (≥26) and low benefit per RSClin (aHR, 1.70; 95% CI, 0.41-6.99). CONCLUSIONS: RSClin may identify high-risk patients who benefit from treatment intensification more accurately than OncotypeDx, and further prospective study is needed.","journal":"Cancer","year":2023,"id":363324,"datarank":0.4793353516171467,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"self_citation_contribution":0.32958368660043297,"citation_network_contribution":0.1497516650167137,"self_endowment_contribution":0.32958368660043297,"citer_contribution":0.1497516650167137,"corpus_percentile":60.215053763440864,"corpus_rank":5144,"citation_count":8,"citer_count":5,"citers_with_citation_signal":4,"citers_with_endowment":4,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5773,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1117787,"name":"Asim Dhungana","orcid":null,"position":1,"is_corresponding":false},{"id":728948,"name":"Fangyuan Zhao","orcid":"0000-0001-9776-3677","position":2,"is_corresponding":false},{"id":568253,"name":"Nan Chen","orcid":"0000-0001-8536-6631","position":3,"is_corresponding":false},{"id":869042,"name":"Sarah P. Shubeck","orcid":"0000-0001-8831-2428","position":4,"is_corresponding":false},{"id":633437,"name":"Olwen Hahn","orcid":null,"position":5,"is_corresponding":false},{"id":242414,"name":"Rita Nanda","orcid":"0000-0001-5248-0876","position":6,"is_corresponding":false},{"id":1105990,"name":"Nora Jaskowiak","orcid":"0000-0003-3624-3891","position":7,"is_corresponding":false},{"id":350751,"name":"Gini F. Fleming","orcid":"0000-0003-2845-4023","position":8,"is_corresponding":false},{"id":6442,"name":"Olufunmilayo I. Olopade","orcid":"0000-0002-9936-1599","position":9,"is_corresponding":false},{"id":110023,"name":"Alexander T. Pearson","orcid":"0000-0003-2801-7456","position":10,"is_corresponding":false},{"id":415422,"name":"Dezheng Huo","orcid":"0000-0002-4041-1678","position":11,"is_corresponding":false},{"id":258977,"name":"Frederick M. Howard","orcid":"0000-0002-6039-1141","position":12,"is_corresponding":false},{"id":733863,"name":"Augustin Vannier","orcid":"0000-0002-9467-0480","position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-07-19T01:14:28.054440Z","pmid":"38146744","pmcid":"PMC10948297","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}