van der Plas-Krijgsman, Willeke G, Morgan, Jenna L, de Glas, Nienke A, de Boer, Anna Z, Martin, Charlene L, Holmes, Geoffrey R, Ward, Susan E, Chater, Tim, Reed, Malcolm W, Merkus, Jos W S, van Dalen, Thijs, Vulink, Annelie J E, van Gerven, Leander, Guicherit, Onno R, Linthorst-Niers, Eugenie, Lans, Titia E, Bastiaannet, Esther, Portielje, Johanneke E A, Liefers, Gerrit Jan and Wyld, Lynda (2022) Differences in treatment and survival of older patients with operable breast cancer between the United Kingdom and the Netherlands – a comparison of two national prospective longitudinal multi-centre cohort studies. European Journal of Cancer, 163. pp. 189-199. ISSN 0959-8049
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Abstract
Background
Previous studies have shown that survival outcomes for older patients with breast cancer vary substantially across Europe, with worse survival reported in the United Kingdom. It has been hypothesised that these differences in survival outcomes could be related to treatment variation.
Objectives
We aimed to compare patient and tumour characteristics, treatment selection and survival outcomes between two large prospective cohorts of older patients with operable breast cancer from the United Kingdom (UK) and The Netherlands.
Methods
Women diagnosed with operable breast cancer aged ≥70 years were included. A baseline comprehensive geriatric assessment was performed in both cohorts, with data collected on age, comorbidities, cognition, nutritional and functional status. Baseline tumour characteristics and treatment type were collected. Univariable and multivariable Cox regression models were used to compare overall survival between the cohorts.
Results
3262 patients from the UK Age Gap cohort and 618 patients from the Dutch Climb cohort were included, with median ages of 77.0 (IQR: 72.0–81.0) and 75.0 (IQR: 72.0–81.0) years, respectively. The cohorts were generally comparable, with slight differences in rates of comorbidity and frailty. Median follow-up for overall survival was 4.1 years (IQR 2.9–5.4) in Age Gap and 4.3 years (IQR 2.9–5.5) in Climb. In Age Gap, both the rates of primary endocrine therapy and adjuvant hormonal therapy after surgery were approximately twice those in Climb (16.6% versus 7.3%, p < 0.001 for primary endocrine therapy, and 62.2% versus 38.8%, p < 0.001 for adjuvant hormonal therapy). There was no evidence of a difference in overall survival between the cohorts (adjusted HR 0.94, 95% CI 0.74–1.17, p = 0.568).
Conclusions
In contrast to previous studies, this comparison of two large national prospective longitudinal multi-centre cohort studies demonstrated comparable survival outcomes between older patients with breast cancer treated in the UK and The Netherlands, despite differences in treatment allocation.
Item Type: | Article |
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Schools and Departments: | Brighton and Sussex Medical School > Clinical and Experimental Medicine |
SWORD Depositor: | Mx Elements Account |
Depositing User: | Mx Elements Account |
Date Deposited: | 28 Jan 2022 08:37 |
Last Modified: | 03 Mar 2022 13:30 |
URI: | http://sro.sussex.ac.uk/id/eprint/103960 |
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📧 Request an updateProject Name | Sussex Project Number | Funder | Funder Ref |
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Bridging the Age Gap: Integration of quality of life outcomes into the decision making of older women with early breast cancer | Unset | NATIONAL INSTITUTE FOR HEALTH RESEARCH | NIHR202048 |