Geographic and Temporal Trends in the Management of Occult Primary Breast Cancer: A Systematic Review and Meta-Analysis

Fayanju, Oluwadamilola M.; Stoll, C; Fowler, Susan A.; Colditz, Graham A.; Jeffe, Donna B.; Margenthaler, Julie A.

doi:10.1245/s10434-013-3157-5

Cited by 15 publications

(13 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study confirms the common use of bevacizumab for second-line systemic therapy, suggesting a pattern of second-line treatment for GB in routine care consistent with the indicated use for bevacizumab. Treatment patterns, patient populations, and outcomes may differ depending on the site of care [ 27 , 28 ]. Thus, it is noteworthy that approximately half of the physicians who prescribed bevacizumab during second-line treatment were affiliated with facilities that included teaching hospitals, whereas a lower percentage of physicians who prescribed bevacizumab were affiliated with NCI-designated comprehensive cancer centers.…”

Section: Discussionmentioning

confidence: 99%

Glioblastoma treatment patterns, survival, and healthcare resource use in real-world clinical practice in the USA

Girvan¹,

Carter²,

Li³

et al. 2015

DIC

View full text Add to dashboard Cite

Background:Glioblastoma (GB) treatment remains challenging because of recurrence and poorly defined treatment options after first-line therapy. To better understand real-world application of treatment paradigms and their impact on outcomes, we describe patterns of treatment, outcomes, and use of cancer-related healthcare resource for glioblastoma in the USA.Methods:A retrospective, online chart-abstraction study was conducted; each participating oncologist contributed ≤5 charts. Patients were ≥18 years with biopsy-confirmed primary or secondary newly diagnosed GB on or after 1 January 2010, had received first- and second-line therapies, and had information collected for ≥3 months after initiation of second-line therapy or until death. Assessments were descriptive and included Kaplan– Meier analyses from initiation to end of second-line therapy, disease progression, or death.Results:One hundred sixty physicians contributed information on 503 patient charts. During first-line therapy, patients most commonly underwent temozolomide monotherapy (76.5%). During second-line therapy, patients most commonly underwent bevacizumab monotherapy (58.1%). Median duration of second-line therapy was 130 days; median time to disease progression was 113 days. Median survival was 153 days. Use of supportive care was observed to be numerically higher in first- compared with second-line therapy except for anti-depressants, growth factors, and stimulants. Frequently used resources included corticosteroids (78.8% of patients in first-line and 62.6% in second-line therapies), anti-epileptics (45.8% and 41.5%) and narcotic opioids (45.3% and 41.4%).Conclusions:Most GB patients received temozolomide during first-line therapy and bevacizumab monotherapy or combination therapy during second-line therapy. Use of supportive care appeared to be higher in first- compared with second-line therapy for some agents.

show abstract

Section: Discussionmentioning

confidence: 99%

Glioblastoma treatment patterns, survival, and healthcare resource use in real-world clinical practice in the USA

Girvan¹,

Carter²,

Li³

et al. 2015

DIC

View full text Add to dashboard Cite

show abstract

“…Although systemic chemotherapy and endocrine therapy are believed to be performed according to the recommendations for their relatively comparative stage, locoregional managements for OBC such as breast conserving surgery (BCS), mastectomy, ALND, or its combinations have been variously implemented [ 8 , 9 ]. Previous studies suggested that BCS or ALND plus RT resulted in similar recurrence and survival rates compared to mastectomy plus ALND [ 5 - 7 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Benefit of Radiotherapy in Patients with Occult Breast Cancer: A Population-Based Analysis of the SEER Database

2018

View full text Add to dashboard Cite

PurposeFew studies for occult breast cancer (OBC) have evaluated the effect of radiotherapy (RT) after mastectomy or axillary lymph node dissection (ALND) with/without breast surgery. Therefore, we investigated clinicopathologic factors of OBC with the impact of postoperative RT to determine its prognostic significance using large population-based data.Materials and MethodsWe performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database from 1983 to 2013. A total of 1,045 eligible patients with OBC were identified. We compared overall survival (OS) using Cox proportional hazards regression with propensity score matching after verifying an imbalance of prognosticators between RT group (n=518) and non-RT group (n=479).ResultsPatients with age < 70 (p=0.033), married marital status (p < 0.001), undergoing ALND (p < 0.001), more examined lymph nodes (LNs) (p < 0.001), and more metastatic LNs (p < 0.001) were more likely to receive RT. Multivariate analysis after propensity score matching (n=798) showed that patients treated with RT survived significantly longer than those without RT (5-year OS, 81.5% vs. 78.3%; p=0.014). A significantly prolonged OS was observed when RT was given to patients treated with mastectomy (p=0.033), those treated with ALND (p=0.036), or those with more than seven metastatic LNs (p=0.016).ConclusionRT may offer survival benefit in OBC even after mastectomy or ALND, especially in patients with more than seven metastatic LNs. Further prospective studies are needed to validate these findings.

show abstract

“…Sixth, considerable geographical differences do exist with regard to various aspects of high‐risk PCa management. A similar scenario has been described among urologists of North America , as well as for the management of other malignancies, such as breast cancer . Possible reasons are disparities in national health systems, the availability of diagnostic and therapeutic technologies and cultural background.…”

Section: Discussionmentioning

confidence: 64%

Preferences in the management of high‐risk prostate cancer among urologists in Europe: results of a web‐based survey

Surcel

Sooriakumaran

Briganti³

et al. 2014

BJU International

View full text Add to dashboard Cite

ObjectiveTo explore preferences in the management of patients with newly diagnosed high‐risk prostate cancer (PCa) among urologists in Europe through a web‐based survey.Materials and MethodsA web‐based survey was conducted between 15 August and 15 September 2013 by members of the Prostate Cancer Working Group of the Young Academic Urologists Working Party of the European Association of Urology (EAU). A specific, 29‐item multiple‐choice questionnaire covering the whole spectrum of diagnosis, staging and treatment of high‐risk PCa was e‐mailed to all urologists included in the mailing list of EAU members. Europe was divided into four geographical regions: Central‐Eastern Europe (CEE), Northern Europe (NE), Southern Europe (SE) and Western Europe (WE). Descriptive statistics were used. Differences among sample segments were obtained from a z‐test compared with the total sample.ResultsOf the 12 850 invited EAU members, 585 urologists practising in Europe completed the survey. High‐risk PCa was defined as serum PSA ≥20 ng/mL or clinical stage ≥ T3 or biopsy Gleason score ≥ 8 by 67% of responders, without significant geographical variations. The preferred single‐imaging examinations for staging were bone scan (74%, 81% in WE and 70% in SE; P = 0.02 for both), magnetic resonance imaging (53%, 72% in WE and 40% in SE; P = 0.02 and P = 0.01, respectively) and computed tomography (45%, 60% in SE and 23% in WE; P = 0.01 for both). Pre‐treatment predictive tools were routinely used by 62% of the urologists, without significant geographical variations. The preferred treatment was radical prostatectomy as the initial step of a multiple‐treatment approach (60%, 40% in NE and 70% in CEE; P = 0.02 and P < 0.01, respectively), followed by external beam radiation therapy with androgen deprivation therapy (29%, 45% in NE and 20% in CEE; P = 0.01 and P = 0.02, respectively), and radical prostatectomy as monotherapy (4%, 7% in WE; P = 0.04). When surgery was performed, the open retropubic approach was the most popular (58%, 74% in CEE, 37% in NE; P < 0.01 for both). Pelvic lymph node dissection was performed by 96% of urologists, equally split between a standard and extended template. There was no consensus on the definition of disease recurrence after primary treatment, and much heterogeneity in the administration of adjuvant and salvage treatments.ConclusionWith the limitation of a low response rate, the present study is the first survey evaluating preferences in the management of high‐risk PCa among urologists in Europe. Although the definition of high‐risk PCa was fairly uniform, wide variations in patterns of primary and adjuvant/salvage treatments were observed. These differences might translate into variations in quality of care with a possible impact on ultimate oncological outcome.

show abstract

Geographic and Temporal Trends in the Management of Occult Primary Breast Cancer: A Systematic Review and Meta-Analysis

Cited by 15 publications

References 54 publications

Glioblastoma treatment patterns, survival, and healthcare resource use in real-world clinical practice in the USA

Glioblastoma treatment patterns, survival, and healthcare resource use in real-world clinical practice in the USA

Evaluation of the Benefit of Radiotherapy in Patients with Occult Breast Cancer: A Population-Based Analysis of the SEER Database

Preferences in the management of high‐risk prostate cancer among urologists in Europe: results of a web‐based survey

Contact Info

Product

Resources

About