Dataset Information

Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program.

ABSTRACT:

Background

Bone-only (BO) metastatic breast cancer (MBC) is considered a more favorable entity than other MBC presentations. However, only few retrospective series and data from selected randomized controlled trials have been reported so far.

Methods

Using the French national multicenter ESME (Epidemiological Strategy and Medico Economics) Data Platform, the primary objective of our study was to compare the overall survival (OS) of patients with BO versus non-BO MBC at diagnosis, with adjustment on main prognostic factors using a propensity score. Secondary objectives were to compare first-line progression-free survival (PFS1), describe treatment patterns, and estimate factors associated with OS.

Results

Out of 20,095 eligible women, 5041 (22.4%) patients had BO disease [hormone-receptor positive (HR+)/human epidermal growth-factor-receptor-2 negative (HER2-), n?=?4 102/13,229 (31%); HER2+, n?=?644/3909 (16.5%); HR-/HER2-, n?=?295/2 957 (10%)]. BO MBC patients had a better adjusted OS compared with non-BO MBC [52.1?months (95% confidence interval (CI) 50.3-54.1) versus 34.7?months (95% CI 34.0-35.6) respectively]. The 5-year OS rate of BO MBC patients was 43.4% (95% CI 41.7-45.2). They also had a better PFS1 [13.1?months (95% CI 12.6-13.8) versus 8.5?months (95% CI 8.3-8.7), respectively]. This observation could be repeated in all subtypes. BO disease was an independent prognostic factor of OS [hazard ratio 0.68 (95% CI 0.65-0.72), p?ConclusionBO MBC patients have better outcomes compared with non-BO MBC, consistently, through all MBC subtypes.

SUBMITTER: Bertho M

PROVIDER: S-EPMC7841864 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program.

Bertho Marion M Fraisse Julien J Patsouris Anne A Cottu Paul P Arnedos Monica M Pérol David D Jaffré Anne A Goncalves Anthony A Lebitasy Marie-Paule MP D'Hondt Véronique V Dalenc Florence F Ferrero Jean-Marc JM Levy Christelle C Dabakuyo Sandrine S Rouzier Roman R Penault-Llorca Frédérique F Uwer Lionel L Eymard Jean-Christophe JC Breton Mathias M Chevrot Michaël M Thureau Sébastien S Petit Thierry T Simon Gaëtane G Frénel Jean-Sébastien JS

Therapeutic advances in medical oncology 20210121

<h4>Background</h4>Bone-only (BO) metastatic breast cancer (MBC) is considered a more favorable entity than other MBC presentations. However, only few retrospective series and data from selected randomized controlled trials have been reported so far.<h4>Methods</h4>Using the French national multicenter ESME (Epidemiological Strategy and Medico Economics) Data Platform, the primary objective of our study was to compare the overall survival (OS) of patients with BO <i>versus</i> non-BO MBC at diag ...[more]

PMID: 33613700

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Project description:BackgroundPrimary inflammatory breast cancer (IBC) is a rare and aggressive entity whose prognosis has been improved by multimodal therapy. However, 5-year overall survival (OS) remains poor. Given its low incidence, the prognosis of IBC at metastatic stage is poorly described.Materials and methodsThis study aimed to compare OS calculated from the diagnosis of metastatic disease between IBC patients and non-IBC patients in the Epidemiological Strategy and Medical Economics database (N = 16 702 patients). Secondary objectives included progression-free survival (PFS) after first-line metastatic treatment, identification of prognostic factors for OS and PFS, and evolution of survival during the study period.ResultsFrom 2008 to 2014, 7465 patients with metastatic breast cancer and known clinical status of their primary tumor (T) were identified (582 IBC and 6883 non-IBC). Compared with metastatic non-IBC, metastatic IBC was associated with less hormone receptor-positive (44% versus 65.6%), more human epidermal growth factor receptor 2-positive (30% versus 18.6%), and more triple-negative (25.9% versus 15.8%) cases, more frequent de novo M1 stage (53.3% versus 27.7%; P < 0.001), and shorter median disease-free interval (2.02 years versus 4.9 years; P < 0.001). With a median follow-up of 50.2 months, median OS was 28.4 months [95% confidence interval (CI) 24.1-33.8 months] versus 37.2 months (95% CI 36.1-38.5 months) in metastatic IBC and non-IBC cases, respectively (P < 0.0001, log-rank test). By multivariate analysis, OS was significantly shorter in the metastatic IBC group compared with the metastatic non-IBC group [hazard ratio = 1.27 (95% CI 1.1-1.4); P = 0.0001]. Survival of metastatic IBC patients improved over the study period: median OS was 24 months (95% CI 20-31.9 months), 29 months (95% CI 21.7-39.9 months), and 36 months (95% CI 27.9-not estimable months) if diagnosis of metastatic disease was carried out until 2010, between 2011 and 2012, and from 2013, respectively (P = 0.003).ConclusionIBC is independently associated with adverse outcome when compared with non-IBC in the metastatic setting.

Project description:BackgroundPrognosis of medically treated trigeminal neuralgia patients is assumed to be poor, but the evidence is lacking. Thus, prospective real-life studies of medical management of trigeminal neuralgia are warranted.MethodsThis was an observational study. Patients were consecutively enrolled in a structured management program at a specialist centre for facial pain. Optimisation of medical treatment, physiotherapy, psychotherapy, and advice from trained nurses, were parts of the program. Medically intractable patients were referred for neurosurgery. Data-collection was prospective using standardised schemes and patient surveys. The aim was to describe the two-year outcome of medical treatment at the specialist centre. The primary outcome was a 50% reduction in the overall burden of pain according to a Numerical Rating Scale (NRS) after two years.ResultsA total of 186 primary TN patients were enrolled in the program of which 103 patients remained medically managed and completed the two-year follow-up. Fifty patients were treated surgically within the first two years of follow-up. Half of the medically managed patients (53 (51%)), had more than a 50% reduction in the overall burden of pain over the two-year period. The overall burden of pain on NRS decreased from mean 5.34 to 3.00, p < 0.01. There was no significant association between primary outcome and sex, depression and/or anxiety, concomitant persistent pain, or neurovascular contact with morphological changes of the trigeminal nerve.ConclusionsPatients with trigeminal neuralgia improve over a two-year period when enrolled in a structured medical management program. Optimisation of drug treatment, continuous advice and education and support by the multidisciplinary team, referral of the medically intractable patients for surgery or the natural history of the disease, can be some of the reasons for the improvement. The favourable prognosis provides hope and optimism for medically managed TN patients.Trial registrationCurrent study was observational, and patients were offered standard clinical care and laboratory workups according to current American Academy of Neurology and European Federation of Neurological Societies treatment guidelines. The study has been registered at ClincalTrials.gov. ID: NCT03838393 .

Dataset Information

Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program.

Background

Methods

Results

Publications

Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program.

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