期刊
SCIENTIFIC REPORTS
卷 11, 期 1, 页码 -出版社
NATURE PORTFOLIO
DOI: 10.1038/s41598-021-84825-2
关键词
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资金
- Instituto de Salud Carlos III-FEDER [RD09/0076/00036, RD09 0076/00058, RD 09 0076/00021]
- Public Health Laboratory of Gipuzkoa
- Basque Biobank
- ICOBIOBANC - Catalan Institute of Oncology
- IUOPA Biobank of the University of Oviedo
- ISCIII Biobank
- Accion Transversal del Cancer
- Instituto de Salud Carlos III
- FEDER funds-'a way to build Europe' [PI08/1770, PI08/0533, PI08/1359, PI09/00773, PI09/01286, PI09/01903, PI09/02078, PI09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150, PI14/01219, PI14/00613, PI15/00069]
- Fundacion Marques de Valdecilla [10/09]
- Junta de Castilla y Leon [LE22A10-2]
- Consejeria de Salud of the Junta de Andalucia [2009-S0143]
- Conselleria de Sanitat of the Generalitat Valenciana [AP 061/10]
- Recercaixa [2010ACUP 00310]
- Regional Government of the Basque Country
- Consejeria de Sanidad de la Region de Murcia
- European Commission grants [FOOD-CT-2006-036224-HIWATE]
- Spanish Association Against Cancer (AECC) Scientific Foundation
- Catalan Government DURSI [2014SGR647]
- Fundacion Caja de Ahorros de Asturias
- University of Oviedo
- Societat Catalana de Digestologia
- COST action [BM1206 Eucolongene]
The study aimed to identify the clinical factors associated with the implementation of the St Gallen-2013 recommendations. Patients who received treatment beyond the recommendations were more likely to have stage II tumors, while those who received less treatment than recommended tended to be older with more severe cancers.
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.
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