TY - JOUR
T1 - Endocrine treatment and incidence of relapse in women with oestrogen receptor-positive breast cancer in Europe: a population-based study.
AU - Sant, Milena
AU - Meneghini, Elisabetta
AU - Bastos, Joana
AU - Rossi, Paolo Giorgi
AU - Guevara, Marcela
AU - Innos, Kaire
AU - Katalinic, Alexander
AU - Majuelo, Leire Gil
AU - Marcos-Gragera, Rafael
AU - Molinié, Florence
AU - Rapiti, Elisabetta
AU - Vizcaino, Ana
AU - Zadnik, Vesna
AU - Minicozzi, Pamela
N1 - Place: Netherlands
PY - 2020/9/1
Y1 - 2020/9/1
N2 - PURPOSE: 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 9595 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 96Belgium, Estonia, Slovenia, Spain)-75Switzerland). ORs of starting ET were lower for women aged textgreater 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, 95.02-5.03); severe comorbidity (SHR 1.94, 95.06-3.55); luminal B, either HER2 negative (SHR 3.06, 95.61-5.79) or positive (SHR 3.10, 95.36-7.07); stage II (SHR 3.20, 95.56-6.57) or stage III (SHR 7.41, 95.48-15.73). ET use increased significantly but differently across countries from 51-85996-1998 to 86-96009-2013. 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.
AB - PURPOSE: 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 9595 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 96Belgium, Estonia, Slovenia, Spain)-75Switzerland). ORs of starting ET were lower for women aged textgreater 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, 95.02-5.03); severe comorbidity (SHR 1.94, 95.06-3.55); luminal B, either HER2 negative (SHR 3.06, 95.61-5.79) or positive (SHR 3.10, 95.36-7.07); stage II (SHR 3.20, 95.56-6.57) or stage III (SHR 7.41, 95.48-15.73). ET use increased significantly but differently across countries from 51-85996-1998 to 86-96009-2013. 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.
M3 - Article
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
SN - 0167-6806
IS - 2
ER -