Annals of Surgical Oncology

, Volume 20, Issue 8, pp 2615–2624 | Cite as

Application of the Adjuvant! Online Model to Korean Breast Cancer Patients: An Assessment of Prognostic Accuracy and Development of an Alternative Prognostic Tool

  • Minkyu Jung
  • Eun Hee Choi
  • Chung Mo Nam
  • Sun Young Rha
  • Hei Cheul Jeung
  • Soo Hyun Lee
  • Woo Ick Yang
  • Jae Kyung Roh
  • Hyun Cheol ChungEmail author
Breast Oncology



Adjuvant! Online (AOL) is a Web-accessible risk-assessment model that predicts the mortality and the benefits of adjuvant therapy for breast cancer.


Using the Yonsei Tumor Registry database, patients with T1–3, N0–3, M0 breast cancer who were treated at the Yonsei Cancer Center between 1986 and 1999 were entered into AOL version 8.0 to calculate survival.


The median age of the study population was 45 years (range, 23–76 years) and the median follow-up duration was 10.8 years (range, 0.1–25.9 years) for all 699 patients. AOL significantly overestimated overall survival (OS) (by 11.1 %, P < 0.001), breast cancer-specific survival (BCSS) (by 11.6 %, P < 0.001), and event free-free survival (EFS) (by 9.25 %, P < 0.001) in Korean patients. Therefore, we developed a Korean version of AOL (KAOL), which is a new model for prognosis based on AOL’s parameters. The observed 10-year OS (61.4 %), BCSS (62.3 %), and EFS (59.1 %) and the KAOL predicted OS (61.5 %), BCSS (63.5 %) and EFS (57.6 %) were not different (P = 0.976, P = 0.771, and P = 0.674, respectively).


AOL was not found to be suitable in Korean patients with breast cancer. The newly developed KAOL accurately predicted 10-year outcomes in Korean breast cancer patients.


Breast Cancer Overall Survival Breast Cancer Patient Breast Conserve Surgery Korean Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported in part by the Korea Science and Engineering Fund (KOSEF) through the Cancer Metastasis Research Center (CMRC) at Yonsei University College of Medicine. (R11-2000-082-03002-0.)

Conflict of interest

The authors declare no conflict of interest.

Supplementary material

10434_2013_2956_MOESM1_ESM.doc (44 kb)
Supplementary material 1 (DOC 44 kb)


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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Minkyu Jung
    • 1
    • 2
    • 3
  • Eun Hee Choi
    • 4
  • Chung Mo Nam
    • 4
  • Sun Young Rha
    • 1
    • 2
    • 3
    • 6
  • Hei Cheul Jeung
    • 1
    • 2
    • 3
  • Soo Hyun Lee
    • 1
    • 2
  • Woo Ick Yang
    • 5
    • 6
  • Jae Kyung Roh
    • 1
    • 2
    • 3
    • 6
  • Hyun Cheol Chung
    • 1
    • 2
    • 3
    • 6
    Email author
  1. 1.Division of Medical Oncology, Department of Internal MedicineYonsei University College of MedicineSeoulKorea
  2. 2.Yonsei Cancer CenterYonsei University College of MedicineSeoulKorea
  3. 3.Cancer Metastasis Research CenterYonsei University College of MedicineSeoulKorea
  4. 4.Department of BiostatisticsYonsei University College of MedicineSeoulKorea
  5. 5.Department of PathologyYonsei University College of MedicineSeoulKorea
  6. 6.BK2 1 Project for Medical ScienceYonsei University College of MedicineSeoulKorea

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