CRITERIA FOR PROGNOSTIC FACTORS AND FOR AN ENHANCED PROGNOSTIC SYSTEM

The American Joint Committee on Cancer proposes the following criteria for evaluating putative prognostic factors: they must be (1) signific ant, (2) independent, and (3) clinically important. Furthermore, we su ggest the criteria for selecting a prognostic system that includes TNM and new prognostic factors. These criteria are: (1) easy for physicia ns to use; (2) provides predictions for all types of cancer; (3) provi des the most accurate relapse and survival predictions at diagnosis an d for every year lived for each patient; (4) provides group survival c urves, where the grouping can be by any variable including outcome and therapy; (5) accommodates missing data and censored patients and is t olerant of noisy and biased data; (6) makes no a priori assumptions re garding the type of data, the distribution of the variables, or the re lationships among the variables; (7) can test putative prognostic fact ors for significance, independence, and clinical importance; (8) accom modates treatment information in the evaluation of prognostic factors; (9) accommodates new putative prognostic factors without changing the model; (10) accommodates emerging diagnostic techniques; (11) provide s information regarding the importance of each predictive variable; an d (12) is automatic.