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

BMC Cancer

Reyn Van Ewijk²  Rolf Kreienberg²  Maria Blettner¹  Florian Ebner²  Wolfgang Janni²  Jochem König¹  Achim Wöckel²  Lukas Schwentner² 

[1]Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, Mainz 55131, Germany

[2]Department of Gynecology and Obstetrics, University Ulm, Prittwitzstraße 43, Ulm 89075, Germany

关键词: Cohort study;    Triple negative;    Survival;    Guideline;    Breast cancer;   

Others  :  1079506
DOI  :  10.1186/1471-2407-13-487

 received in 2013-07-04, accepted in 2013-10-11,  发布年份 2013

【 摘 要 】

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%), 50–64 (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.

【 授权许可】

   
2013 Schwentner et al.; licensee BioMed Central Ltd.

【 图 表 】

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