Is guideline-adherent adjuvant treatment an equal alternative for patients aged >65 who cannot participate in adjuvant clinical breast cancer trials? A retrospective multi-center cohort study of 4,142 patients

Publikationstyp:
Zeitschriftenaufsatz
Metadaten:
Autoren
  • R Van Ewijk
  • A Wöckel
  • T Gundelach
  • K Hancke
  • W Janni
  • S Singer
  • R Kreienberg
  • M Blettner
  • L Schwentner
DOI
10.1007/s00404-014-3438-7
eISSN
1432-0711
ISSN
0932-0067
Ausgabe der Veröffentlichung
3
Zeitschrift
Archives of Gynecology and Obstetrics
Sprache
en
Online publication date
2014
Paginierung
631 - 640
Datum der Veröffentlichung
2015
Status
Published
Herausgeber
Springer Science and Business Media LLC
Herausgeber URL
http://dx.doi.org/10.1007/s00404-014-3438-7
Datum der Datenerfassung
2019
Titel
Is guideline-adherent adjuvant treatment an equal alternative for patients aged >65 who cannot participate in adjuvant clinical breast cancer trials? A retrospective multi-center cohort study of 4,142 patients
Ausgabe der Zeitschrift
291

Datenquelle: Crossref

Andere Metadatenquellen:
Abstract
<h4>Introduction</h4>It is well accepted that innovation in oncology is transported through randomized clinical trials (CT), furthermore there is some evidence that patients profit from participation in CT. However, especially elderly patients aged >65 usually do not have access to clinical trials; we therefore used an unselected patient cohort to investigate the following questions: (1) Is there a difference in survival parameters between study participants <65 and elderly 65-80 non-participants? (2) Is guideline-adherent adjuvant treatment an equal alternative for elderly patients aged 65-80?<h4>Materials and methods</h4>This German retrospective multi-center cohort study included 4,142 patients (study participants <65 and elderly breast cancer patients 65-80) with primary breast cancer recruited from 1992 to 2008 in 17 participating breast cancer centers.<h4>Results</h4>Applying the exclusion criteria, we included 960 (23.2%) study participants (PA) <65 and 3,182 (76.8%) elderly >65. Elderly non-participants (NPA) >65 demonstrate a significantly inferior RFS [RFS: HR = 1.67; p < 0.001] and OS [OS: HR = 1.98; p < 0.001] compared to PA <65. Within the elderly group, 1,868 (58.7%) patients received guideline-adherent adjuvant treatment. When comparing guideline conform elderly >65 versus PA <65, we found no significant difference in RFS [RFS: HR = 1.17; p = 0.218] and OS [OS: HR = 1.34; p = 0.054]. In contrast, non-guideline-adherent elderly demonstrated significantly inferior survival parameters [RFS: HR = 2.06; p < 0.001] [OS: HR = 2.50; p < 0.001] compared to <65 PA.<h4>Conclusion</h4>Guideline-adherent adjuvant treatment seems to be an equivalent option for elderly breast cancer patients. There is a strong association between guideline adherence and improved outcome parameters in elderly breast cancer patients.
Addresses
  • Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
Autoren
  • R Van Ewijk
  • A Wöckel
  • T Gundelach
  • K Hancke
  • W Janni
  • S Singer
  • R Kreienberg
  • M Blettner
  • L Schwentner
DOI
10.1007/s00404-014-3438-7
eISSN
1432-0711
Externe Identifier
  • PubMed Identifier: 25178186
Open access
false
ISSN
0932-0067
Ausgabe der Veröffentlichung
3
Zeitschrift
Archives of gynecology and obstetrics
Schlüsselwörter
  • Humans
  • Breast Neoplasms
  • Treatment Outcome
  • Survival Analysis
  • Retrospective Studies
  • Cohort Studies
  • Age Factors
  • Adult
  • Aged
  • Aged, 80 and over
  • Patient Participation
  • Guideline Adherence
  • Female
  • Clinical Trials as Topic
Sprache
eng
Medium
Print-Electronic
Online publication date
2014
Paginierung
631 - 640
Datum der Veröffentlichung
2015
Status
Published
Datum der Datenerfassung
2014
Titel
Is guideline-adherent adjuvant treatment an equal alternative for patients aged >65 who cannot participate in adjuvant clinical breast cancer trials? A retrospective multi-center cohort study of 4,142 patients.
Sub types
  • Research Support, Non-U.S. Gov't
  • Multicenter Study
  • Journal Article
Ausgabe der Zeitschrift
291

Datenquelle: Europe PubMed Central

Abstract
INTRODUCTION: It is well accepted that innovation in oncology is transported through randomized clinical trials (CT), furthermore there is some evidence that patients profit from participation in CT. However, especially elderly patients aged >65 usually do not have access to clinical trials; we therefore used an unselected patient cohort to investigate the following questions: (1) Is there a difference in survival parameters between study participants <65 and elderly 65-80 non-participants? (2) Is guideline-adherent adjuvant treatment an equal alternative for elderly patients aged 65-80? MATERIALS AND METHODS: This German retrospective multi-center cohort study included 4,142 patients (study participants <65 and elderly breast cancer patients 65-80) with primary breast cancer recruited from 1992 to 2008 in 17 participating breast cancer centers. RESULTS: Applying the exclusion criteria, we included 960 (23.2%) study participants (PA) <65 and 3,182 (76.8%) elderly >65. Elderly non-participants (NPA) >65 demonstrate a significantly inferior RFS [RFS: HR = 1.67; p < 0.001] and OS [OS: HR = 1.98; p < 0.001] compared to PA <65. Within the elderly group, 1,868 (58.7%) patients received guideline-adherent adjuvant treatment. When comparing guideline conform elderly >65 versus PA <65, we found no significant difference in RFS [RFS: HR = 1.17; p = 0.218] and OS [OS: HR = 1.34; p = 0.054]. In contrast, non-guideline-adherent elderly demonstrated significantly inferior survival parameters [RFS: HR = 2.06; p < 0.001] [OS: HR = 2.50; p < 0.001] compared to <65 PA. CONCLUSION: Guideline-adherent adjuvant treatment seems to be an equivalent option for elderly breast cancer patients. There is a strong association between guideline adherence and improved outcome parameters in elderly breast cancer patients.
Date of acceptance
2014
Autoren
  • R Van Ewijk
  • A Wöckel
  • T Gundelach
  • K Hancke
  • W Janni
  • S Singer
  • R Kreienberg
  • M Blettner
  • L Schwentner
Autoren-URL
https://www.ncbi.nlm.nih.gov/pubmed/25178186
DOI
10.1007/s00404-014-3438-7
eISSN
1432-0711
Ausgabe der Veröffentlichung
3
Zeitschrift
Arch Gynecol Obstet
Schlüsselwörter
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms
  • Clinical Trials as Topic
  • Cohort Studies
  • Female
  • Guideline Adherence
  • Humans
  • Patient Participation
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
Sprache
eng
Country
Germany
Paginierung
631 - 640
Datum der Veröffentlichung
2015
Status
Published
Datum, an dem der Datensatz öffentlich gemacht wurde
2015
Titel
Is guideline-adherent adjuvant treatment an equal alternative for patients aged >65 who cannot participate in adjuvant clinical breast cancer trials? A retrospective multi-center cohort study of 4,142 patients.
Sub types
  • Journal Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
Ausgabe der Zeitschrift
291

Datenquelle: PubMed

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