Dataset Information

Management and outcome of male metastatic breast cancer in the national multicenter observational research program Epidemiological Strategy and Medical Economics (ESME).

ABSTRACT:

Background and aims

Because of its low prevalence, metastatic breast cancer (MBC) in males is managed based on clinical experience with women. Using a real-life database, we aim to provide a comprehensive analysis of male MBC characteristics, management and outcome.

Methods

The Epidemiological Strategy and Medical Economics Data Platform collected data for all men and women ?18?years with MBC in 18 participating French Comprehensive Cancer Centers from January 2008 to November 2016. Demographic, clinical, and pathological characteristics were retrieved, as was treatment modality. Men were matched 1:1 to women with similar characteristics.

Results

Of 16,701 evaluable patients, 149 (0.89%) men were identified. These men were older (median age 69?years) and predominantly had hormone receptor HR+/HER2- disease (78.3%). Median overall survival (OS) was 41.8?months [95% confidence interval (CI: 26.9-49.7)] and similar to women. Median progression-free survival (PFS) with first-line therapy was 9.3?months [95% CI (7.4-11.5)]. In the HR+/HER2- subpopulation, endocrine therapy (ET) alone was the frontline treatment for 43% of patients, including antiestrogens (n?=?19), aromatase inhibitors (n?=?15) with luteinizing hormone-releasing hormone (LHRH) analogs (n?=?3), and various sequential treatments. Median PFS achieved by frontline ET alone was similar in men [9.8?months, 95% CI (6.9-17.4)] and in women [13?months, 95% CI (8.4-30.9)] (p?=?0.80). PFS was similar for HR+/HER2- men receiving upfront ET or chemotherapy: 9.8?months [95% CI (6.9-17.4)] versus 9.5?months [95% CI (7.4-11.7)] (p?=?0.22), respectively.

Conclusion

MBC management in men and women leads to similar outcomes, especially in HR+/HER2- patients for whom ET should also be a cornerstone. Unsolved questions remain and successfully recruiting trials for men are still lacking.

SUBMITTER: Sirieix J

PROVIDER: S-EPMC7768846 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

Management and outcome of male metastatic breast cancer in the national multicenter observational research program Epidemiological Strategy and Medical Economics (ESME).

Sirieix Junien J Fraisse Julien J Mathoulin-Pelissier Simone S Leheurteur Marianne M Vanlemmens Laurence L Jouannaud Christelle C Diéras Véronique V Lévy Christelle C Ung Mony M Mouret-Reynier Marie-Ange MA Petit Thierry T Coudert Bruno B Brain Etienne E Pistilli Barbara B Ferrero Jean-Marc JM Goncalves Anthony A Uwer Lionel L Patsouris Anne A Tredan Olivier O Courtinard Coralie C Gourgou Sophie S Frénel Jean-Sébastien JS

Therapeutic advances in medical oncology 20201223

<h4>Background and aims</h4>Because of its low prevalence, metastatic breast cancer (MBC) in males is managed based on clinical experience with women. Using a real-life database, we aim to provide a comprehensive analysis of male MBC characteristics, management and outcome.<h4>Methods</h4>The Epidemiological Strategy and Medical Economics Data Platform collected data for all men and women ⩾18 years with MBC in 18 participating French Comprehensive Cancer Centers from January 2008 to November 201 ...[more]

PMID: 33488779

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Project description:BackgroundSepsis is a major health care problem with high morbidity and mortality rates and affects millions of patients. Telemedicine, defined as the exchange of medical information via electronic communication, improves the outcome of patients with sepsis and decreases the mortality rate and length of stay in the intensive care unit (ICU). Additional telemedicine rounds could be an effective component of performance-improvement programs for sepsis, especially in underserved rural areas and hospitals without ready access to critical care physicians.ObjectiveOur aim was to evaluate the impact of additional daily telemedicine rounds on adherence to sepsis bundles. We hypothesized that additional telemedicine support may increase adherence to sepsis guidelines and improve the detection rates of sepsis and septic shock.MethodsWe conducted a retrospective, observational, multicenter study between January 2014 and July 2015 with one tele-ICU center and three ICUs in Germany. We implemented telemedicine as part of standard care and collected data continuously during the study. During the daily telemedicine rounds, routine screening for sepsis was conducted and adherence to the Surviving Sepsis Campaign's 3-hour and 6-hour sepsis bundles were evaluated.ResultsIn total, 1168 patients were included in this study, of which 196 were positive for severe sepsis and septic shock. We found that additional telemedicine rounds improved adherence to the 3-hour (Quarter 1, 35% vs Quarter 6, 76.2%; P=.01) and 6-hour (Quarter 1, 50% vs Quarter 6, 95.2%; P=.001) sepsis bundles. In addition, we noted an increase in adherence to the item "Administration of fluids when hypotension" (Quarter 1, 80% vs Quarter 6, 100%; P=.049) of the 3-hour bundle and the item "Remeasurement of lactate" (Quarter 1, 65% vs Quarter 6, 100%, P=.003) of the 6-hour bundle. The ICU length of stay after diagnosis of severe sepsis and septic shock remained unchanged over the observation period. Due to a higher number of patients with sepsis in Quarter 5 (N=60) than in other quarters, we observed stronger effects of the additional rounds on mortality in this quarter (Quarter 1, 50% vs Quarter 5, 23.33%, P=.046).ConclusionsAdditional telemedicine rounds are an effective component of and should be included in performance-improvement programs for sepsis management.

Dataset Information

Management and outcome of male metastatic breast cancer in the national multicenter observational research program Epidemiological Strategy and Medical Economics (ESME).

Background and aims

Methods

Results

Conclusion

Publications

Management and outcome of male metastatic breast cancer in the national multicenter observational research program Epidemiological Strategy and Medical Economics (ESME).

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