Avtor/Urednik | Sant, Milena; Meneghini, Elisabetta; Bastos, Joana; Rossi, Gian Paolo; Guevara, Marcela; Innos, Kaire; Katalinic, Alexander; Majuelo, Leire Gil; Marcos-Gragera, Rafael; Zadnik, Vesna | |
Naslov | Endocrine treatment and incidence of relapse in women with oestrogen receptor-positive breast cancer in Europe | |
Tip | članek | |
Vol. in št. | Letnik 183, št. 2 | |
Leto izdaje | 2020 | |
Obseg | str. 439-450 | |
ISSN | 0167-6806 - Breast cancer research and treatment | |
Jezik | eng | |
Abstrakt | Endocrine therapy (ET) is the mainstream adjuvant treatment for ER-positive breast cancer (BC). We analysed 9293 ER-positive BC patients diagnosed in nine European countries in 2009-2013 to investigate how comorbidities at diagnosis, age, stage and subtype affected ET use over time, and relapse. Methods: Adjusted odds ratios (ORs) and 95% confidence intervals (95%CIs) of receiving ET were estimated according to Charlson comorbidity, age, stage and subtype using logistic regression. The 2-year cumulative incidence and adjusted sub-hazard ratios (SHRs) of relapse were estimated using competing risk analysis, with all-cause death as the competing event. The z-test was used to assess differences in the proportion of patients receiving ET in 1996-1998 and 2009-2013. Results: Ninety percent of the patients started adjuvant ET, range 96% (Belgium, Estonia, Slovenia, Spain)-75% (Switzerland). ORs of starting ET were lower for women aged > 75 years, with severe comorbidities, or luminal B HER2-positive cancer. The factors independently increasing the risk of relapse were: not receiving ET (SHR 2.26, 95%CI 1.02-5.03); severe comorbidity (SHR 1.94, 95%CI 1.06-3.55); luminal B, either HER2 negative (SHR 3.06, 95%CI 1.61-5.79) or positive (SHR 3.10, 95%CI 1.36-7.07); stage II (SHR 3.20, 95%CI 1.56-6.57) or stage III (SHR 7.41, 95%CI 3.48-15.73). ET use increased significantly but differently across countries from 51-85% in 1996-1998 to 86-96% in 2009-2013. Conclusions: ER-positive BC patients in Europe are increasingly prescribed ET but between-country disparities persist. Older women and women with severe comorbidity less frequently receive ET. ET omission and severe comorbidity independently predict early disease relapse. | |
Proste vsebinske oznake | rak dojke estrogen endokrinološko zdravljenje register raka breast cancer oestrogen endocrine treament cancer registry |