Adherence to treatment guidelines and survival in triple-negative breast cancer: a retrospective multi-center cohort study with 9156 patients

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• 作者：Lukas Schwentner (8)
  Achim W?ckel (8)
  Jochem K?nig (9)
  Wolfgang Janni (8)
  Florian Ebner (8)
  Maria Blettner (9)
  Rolf Kreienberg (8)
  Reyn Van Ewijk (8)
  
• 关键词：Breast cancer ; Guideline ; Survival ; Triple negative ; Cohort study
• 刊名：BMC Cancer
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：449 KB
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  28. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/13/487/prepub
  
• 作者单位：Lukas Schwentner (8)
  Achim W?ckel (8)
  Jochem K?nig (9)
  Wolfgang Janni (8)
  Florian Ebner (8)
  Maria Blettner (9)
  Rolf Kreienberg (8)
  Reyn Van Ewijk (8)
  
  8. Department of Gynecology and Obstetrics, University Ulm, Prittwitzstra?e 43, Ulm, 89075, Germany
  9. Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Obere Zahlbacher Stra?e 69, Mainz, 55131, Germany
  
• ISSN：1471-2407

文摘

Background Triple-negative breast cancer (TNBC) remains a challenging topic for clinical oncologists. This study sought to evaluate TNBC versus other breast cancer subtypes with respect to survival parameters. We evaluated possible differences in survival in TNBC by age and by the extent to which evidence-based treatment guidelines were adhered. Methods This German retrospective multi-center cohort study included 9156 patients with primary breast cancer recruited from 1992 to 2008. Results The rates of guideline adherence are significantly lower in TNBC compared to non-TNBC subtypes. These lower rates of guideline adherence can be observed in all age groups and are most pronounced in the >65 subgroup [<50 (20.9% vs. 42.0%), 50-4 (25.1% vs. 51.1%), and >65 (38.4% vs. 74.6%)]. In TNBC patients of all age groups, disease-free survival and overall survival were associated with an improvement by 100% guideline-adherent adjuvant treatment compared to non-adherence. Furthermore, TNBC patients of all ages had similar outcome parameters if 100% guideline-adherent adjuvant treatment was applied. Conclusion The rates of guideline-adherent treatment were significantly lower in TNBC, even though guideline adherence was strongly associated with improved survival. In the case of 100% guideline-adherent treatment, no difference in survival was observed over all the age groups examined, even in the group of >65-year-old TNBC patients.