Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study

The St Gallen Conference endorsed in 2013 a series of recommendations on early breast cancer treatment. The main purpose of this article is to ascertain the clinical factors associated with St Gallen-2013 recommendations accomplishment. A cohort of 1152 breast cancer cases diagnosed with pathologica...

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Autores: Gómez-Acebo I, Dierssen-Sotos T, Mirones M, Pérez-Gómez B, Guevara M, Amiano P, Sala M, Molina AJ, Alonso-Molero J, Moreno V, Suarez-Calleja C, Molina-Barceló A, Alguacil J, Marcos-Gragera R, Fernández-Ortiz M, Sanz-Guadarrama O, Castaño-Vinyals G, Gil-Majuelo L, Moreno-Iribas C, Aragonés N, Kogevinas M, Pollán M, Llorca J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p9184
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/9184
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102707447&doi=10.1038%2fs41598-021-84825-2&partnerID=40&md5=37b8de0da2809d23dbd52bac756ec926
Access Level:acceso abierto
Palabra clave:Adult
Aged
Breast Neoplasms
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Follow-Up Studies
Humans
Middle Aged
Models, Biological
Neoplasm Staging
Retrospective Studies
Spain
Survival Rate
adjuvant chemotherapy
adult
aged
biological model
breast tumor
cancer staging
clinical trial
disease free survival
epidemiology
female
follow up
human
metabolism
middle aged
mortality
multicenter study
retrospective study
survival rate
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network_acronym_str ES
network_name_str España
repository_id_str
spelling Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain studyGómez-Acebo IDierssen-Sotos TMirones MPérez-Gómez BGuevara MAmiano PSala MMolina AJAlonso-Molero JMoreno VSuarez-Calleja CMolina-Barceló AAlguacil JMarcos-Gragera RFernández-Ortiz MSanz-Guadarrama OCastaño-Vinyals GGil-Majuelo LMoreno-Iribas CAragonés NKogevinas MPollán MLlorca JAdultAgedBreast NeoplasmsChemotherapy, AdjuvantDisease-Free SurvivalFemaleFollow-Up StudiesHumansMiddle AgedModels, BiologicalNeoplasm StagingRetrospective StudiesSpainSurvival Rateadjuvant chemotherapyadultagedbiological modelbreast tumorcancer stagingclinical trialdisease free survivalepidemiologyfemalefollow uphumanmetabolismmiddle agedmortalitymulticenter studyretrospective studySpainsurvival rateThe St Gallen Conference endorsed in 2013 a series of recommendations on early breast cancer treatment. The main purpose of this article is to ascertain the clinical factors associated with St Gallen-2013 recommendations accomplishment. A cohort of 1152 breast cancer cases diagnosed with pathological stage <3 in Spain between 2008 and 2013 was begun and then followed-up until 2017/2018. Data on patient and tumour characteristics were obtained from medical records, as well as their first line treatment. First line treatments were classified in three categories, according on whether they included the main St Gallen-2013 recommendations, more than those recommended or less than those recommended. Multinomial logistic regression models were carried out to identify factors associated with this classification and Weibull regression models were used to find out the relationship between this classification and survival. About half of the patients were treated according to St Gallen recommendations; 21% were treated over what was recommended and 33% received less treatment than recommended. Factors associated with treatment over the recommendations were stage II (relative risk ratio [RRR]=4.2, 2.9-5.9), cancer positive to either progesterone (RRR=8.1, 4.4-14.9) or oestrogen receptors (RRR=5.7, 3.0-11.0). Instead, factors associated with lower probability of treatment over the recommendations were age (RRR=0.7 each 10 years, 0.6-0.8), poor differentiation (RRR=0.09, 0.04-0.19), HER2 positive (RRR=0.46, 0.26-0.81) and triple negative cancer (RRR=0.03, 0.01-0.11). Patients treated less than what was recommended in St Gallen had cancers in stage 0 (RRR=21.6, 7.2-64.5), poorly differentiated (RRR=1.9, 1.2-2.9), HER2 positive (RRR=3.4, 2.4-4.9) and luminal B-like subtype (RRR=3.6, 2.6-5.1). Women over 65 years old had a higher probability of being treated less than what was recommended if they had luminal B-like, HER2 or triple negative cancer. Treatment over St Gallen was associated with younger women and less severe cancers, while treatment under St Gallen was associated with older women, more severe cancers and cancers expressing HER2 receptors.NATURE PORTFOLIO2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/9184https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102707447&doi=10.1038%2fs41598-021-84825-2&partnerID=40&md5=37b8de0da2809d23dbd52bac756ec926Scientific ReportsISSN: 20452322reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p91842026-06-11T12:45:17Z
dc.title.none.fl_str_mv Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
title Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
spellingShingle Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
Gómez-Acebo I
Adult
Aged
Breast Neoplasms
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Follow-Up Studies
Humans
Middle Aged
Models, Biological
Neoplasm Staging
Retrospective Studies
Spain
Survival Rate
adjuvant chemotherapy
adult
aged
biological model
breast tumor
cancer staging
clinical trial
disease free survival
epidemiology
female
follow up
human
metabolism
middle aged
mortality
multicenter study
retrospective study
Spain
survival rate
title_short Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
title_full Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
title_fullStr Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
title_full_unstemmed Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
title_sort Adequacy of early-stage breast cancer systemic adjuvant treatment to Saint Gallen-2013 statement: the MCC-Spain study
dc.creator.none.fl_str_mv Gómez-Acebo I
Dierssen-Sotos T
Mirones M
Pérez-Gómez B
Guevara M
Amiano P
Sala M
Molina AJ
Alonso-Molero J
Moreno V
Suarez-Calleja C
Molina-Barceló A
Alguacil J
Marcos-Gragera R
Fernández-Ortiz M
Sanz-Guadarrama O
Castaño-Vinyals G
Gil-Majuelo L
Moreno-Iribas C
Aragonés N
Kogevinas M
Pollán M
Llorca J
author Gómez-Acebo I
author_facet Gómez-Acebo I
Dierssen-Sotos T
Mirones M
Pérez-Gómez B
Guevara M
Amiano P
Sala M
Molina AJ
Alonso-Molero J
Moreno V
Suarez-Calleja C
Molina-Barceló A
Alguacil J
Marcos-Gragera R
Fernández-Ortiz M
Sanz-Guadarrama O
Castaño-Vinyals G
Gil-Majuelo L
Moreno-Iribas C
Aragonés N
Kogevinas M
Pollán M
Llorca J
author_role author
author2 Dierssen-Sotos T
Mirones M
Pérez-Gómez B
Guevara M
Amiano P
Sala M
Molina AJ
Alonso-Molero J
Moreno V
Suarez-Calleja C
Molina-Barceló A
Alguacil J
Marcos-Gragera R
Fernández-Ortiz M
Sanz-Guadarrama O
Castaño-Vinyals G
Gil-Majuelo L
Moreno-Iribas C
Aragonés N
Kogevinas M
Pollán M
Llorca J
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Adult
Aged
Breast Neoplasms
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Follow-Up Studies
Humans
Middle Aged
Models, Biological
Neoplasm Staging
Retrospective Studies
Spain
Survival Rate
adjuvant chemotherapy
adult
aged
biological model
breast tumor
cancer staging
clinical trial
disease free survival
epidemiology
female
follow up
human
metabolism
middle aged
mortality
multicenter study
retrospective study
Spain
survival rate
topic Adult
Aged
Breast Neoplasms
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Follow-Up Studies
Humans
Middle Aged
Models, Biological
Neoplasm Staging
Retrospective Studies
Spain
Survival Rate
adjuvant chemotherapy
adult
aged
biological model
breast tumor
cancer staging
clinical trial
disease free survival
epidemiology
female
follow up
human
metabolism
middle aged
mortality
multicenter study
retrospective study
Spain
survival rate
description The St Gallen Conference endorsed in 2013 a series of recommendations on early breast cancer treatment. The main purpose of this article is to ascertain the clinical factors associated with St Gallen-2013 recommendations accomplishment. A cohort of 1152 breast cancer cases diagnosed with pathological stage <3 in Spain between 2008 and 2013 was begun and then followed-up until 2017/2018. Data on patient and tumour characteristics were obtained from medical records, as well as their first line treatment. First line treatments were classified in three categories, according on whether they included the main St Gallen-2013 recommendations, more than those recommended or less than those recommended. Multinomial logistic regression models were carried out to identify factors associated with this classification and Weibull regression models were used to find out the relationship between this classification and survival. About half of the patients were treated according to St Gallen recommendations; 21% were treated over what was recommended and 33% received less treatment than recommended. Factors associated with treatment over the recommendations were stage II (relative risk ratio [RRR]=4.2, 2.9-5.9), cancer positive to either progesterone (RRR=8.1, 4.4-14.9) or oestrogen receptors (RRR=5.7, 3.0-11.0). Instead, factors associated with lower probability of treatment over the recommendations were age (RRR=0.7 each 10 years, 0.6-0.8), poor differentiation (RRR=0.09, 0.04-0.19), HER2 positive (RRR=0.46, 0.26-0.81) and triple negative cancer (RRR=0.03, 0.01-0.11). Patients treated less than what was recommended in St Gallen had cancers in stage 0 (RRR=21.6, 7.2-64.5), poorly differentiated (RRR=1.9, 1.2-2.9), HER2 positive (RRR=3.4, 2.4-4.9) and luminal B-like subtype (RRR=3.6, 2.6-5.1). Women over 65 years old had a higher probability of being treated less than what was recommended if they had luminal B-like, HER2 or triple negative cancer. Treatment over St Gallen was associated with younger women and less severe cancers, while treatment under St Gallen was associated with older women, more severe cancers and cancers expressing HER2 receptors.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/9184
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102707447&doi=10.1038%2fs41598-021-84825-2&partnerID=40&md5=37b8de0da2809d23dbd52bac756ec926
url https://fisabio.portalinvestigacion.com/publicaciones/9184
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102707447&doi=10.1038%2fs41598-021-84825-2&partnerID=40&md5=37b8de0da2809d23dbd52bac756ec926
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv NATURE PORTFOLIO
publisher.none.fl_str_mv NATURE PORTFOLIO
dc.source.none.fl_str_mv Scientific Reports
ISSN: 20452322
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
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repository.mail.fl_str_mv
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