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一项针对初始诊断为激素受体阳性晚期乳腺癌患者内分泌治疗管理的欧洲观察性研究。

A European, Observational Study of Endocrine Therapy Administration in Patients With an Initial Diagnosis of Hormone Receptor-Positive Advanced Breast Cancer.

机构信息

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.

National Cancer Registration and Analysis Service, Public Health England, Birmingham, United Kingdom.

出版信息

Clin Breast Cancer. 2018 Aug;18(4):e613-e619. doi: 10.1016/j.clbc.2017.11.019. Epub 2017 Nov 29.

Abstract

BACKGROUND

Despite guideline recommendations, reports suggest that a proportion of patients with hormone receptor (HR)-positive locally advanced or metastatic breast cancer (LA/MBC) might not receive endocrine therapy. The aims of this study were to estimate the proportion of postmenopausal patients with an initial (primary) diagnosis of HR-positive LA/MBC in Europe, and to assess the administration of endocrine treatment in these patients. MATERIALS AND METHODS: Fourteen national and regional cancer registries across Europe were invited to participate in this observational study. Six registries each provided anonymized clinical information on > 5000 postmenopausal women with breast cancer diagnosed between January 2000 and December 2014, including age at diagnosis, estrogen and/or progesterone receptor status, disease stage, and receipt of endocrine therapy. The proportion of patients with an initial diagnosis of HR-positive LA/MBC and, of these, the proportion who received endocrine therapy, was calculated.

RESULTS

Registries from Belgium, England, Ireland, Norway, The Netherlands, and Munich, Germany provided data. In total, 316,680 postmenopausal women were diagnosed with breast cancer, including 244,268 with known HR status and disease stage. Of these patients, 19,002 (7.8%) had a primary diagnosis of HR-positive LA/MBC. This proportion ranged from 5.4% (N = 4484) in England to 12.7% (N = 4085) in Germany. Most of these patients (n = 14,157; 74.5%) received endocrine treatment, ranging from 55.5% (n = 445) in Norway to 88.1% (n = 443) in Belgium.

CONCLUSION

These results indicate that a sizeable proportion of postmenopausal patients in Europe received a primary diagnosis of HR-positive LA/MBC, and that almost three-quarters received subsequent endocrine therapy as per guideline recommendations.

摘要

背景

尽管有指南推荐,但报告显示,一部分激素受体(HR)阳性局部晚期或转移性乳腺癌(LA/MBC)患者可能未接受内分泌治疗。本研究旨在评估欧洲初诊(原发性)HR 阳性 LA/MBC 绝经后患者的比例,并评估这些患者内分泌治疗的应用情况。

材料与方法

欧洲 14 个国家和地区癌症登记处受邀参与这项观察性研究。其中 6 个登记处各提供了 5000 多名绝经后女性的匿名临床信息,这些女性均在 2000 年 1 月至 2014 年 12 月间确诊为乳腺癌,包括诊断时的年龄、雌激素和/或孕激素受体状态、疾病分期和接受内分泌治疗的情况。计算了初诊为 HR 阳性 LA/MBC 的患者比例,以及这些患者中接受内分泌治疗的比例。

结果

比利时、英格兰、爱尔兰、挪威、荷兰和德国慕尼黑的登记处提供了数据。共诊断出 316680 例绝经后女性乳腺癌患者,其中 244268 例患者 HR 状态和疾病分期已知。这些患者中,19002 例(7.8%)初诊为 HR 阳性 LA/MBC。这一比例从英格兰的 5.4%(n=4484)到德国的 12.7%(n=4085)不等。这些患者中,大多数(n=14157;74.5%)接受了内分泌治疗,从挪威的 55.5%(n=445)到比利时的 88.1%(n=443)不等。

结论

这些结果表明,欧洲相当一部分绝经后患者初诊为 HR 阳性 LA/MBC,并且根据指南推荐,近 3/4 的患者接受了后续内分泌治疗。

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