Guideline concordant therapy improves survival in high-grade endometrial cancer patients.
Endometrial cancer
Guideline concordant therapy
High grade
S3 guideline
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
26
05
2022
accepted:
22
08
2022
medline:
19
7
2023
pubmed:
15
10
2022
entrez:
14
10
2022
Statut:
ppublish
Résumé
Data from randomized controlled trials in high-grade endometrial cancer are scarce due to its low prevalence. Therefore, guideline recommendations in this cancer subtype rely on relatively few randomized trials and data from retrospective studies. The aim of this study was to evaluate the benefits from guideline-concordant therapy in high-grade endometrial cancer in a real-world patient group. The effect of treatment according to German S3 guidelines and the former S2k guideline on overall survival (OS) and recurrence-free survival (RFS) was evaluated in a cohort of 293 high-grade endometrial cancer patients. Treatment concordant with the S3 guideline significantly improved OS (HR 0.623, CI 0.420-0.923, p = 0.018) and RFS (HR 0.578, CI 0.387-0.863, p = 0.007). Treatment concordant with the S2k guideline did not result in a significantly higher OS (HR 0.783, CI 0.465-1.316, p = 0.335) or RFS (HR 0.741, CI 0.347-1.740, p = 0.242). Therapy according to the German S3 guideline improved OS and RFS in univariate as well as multivariate analysis in this cohort of high-grade endometrial cancer patients.
Identifiants
pubmed: 36239795
doi: 10.1007/s00432-022-04318-1
pii: 10.1007/s00432-022-04318-1
pmc: PMC10349781
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4761-4769Informations de copyright
© 2022. The Author(s).
Références
Ahmed HZ, Liu Y, O’Connell K et al (2017) Guideline-concordant care improves overall survival for locally advanced non-small-cell lung carcinoma patients: a national cancer database analysis. Clin Lung Cancer 18:706–718. https://doi.org/10.1016/j.cllc.2017.04.009
doi: 10.1016/j.cllc.2017.04.009
pubmed: 28601387
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383. https://doi.org/10.1016/0021-9681(87)90171-8
doi: 10.1016/0021-9681(87)90171-8
pubmed: 3558716
de Boer SM, Powell ME, Mileshkin L et al (2018) Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial. Lancet Oncol 19:295–309. https://doi.org/10.1016/S1470-2045(18)30079-2
doi: 10.1016/S1470-2045(18)30079-2
pubmed: 29449189
pmcid: 5840256
Dholakia J, Llamocca E, Quick A et al (2020) Guideline-concordant treatment is associated with improved survival among women with non-endometrioid endometrial cancer. Gynecol Oncol 157:716–722. https://doi.org/10.1016/j.ygyno.2020.03.016
doi: 10.1016/j.ygyno.2020.03.016
pubmed: 32217002
pmcid: 7293554
Felix AS, McLaughlin EM, Caan BJ et al (2020) Guideline-concordant endometrial cancer treatment and survival in the women’s health initiative life and longevity after cancer study. Int J Cancer 147:404–412. https://doi.org/10.1002/ijc.32740
doi: 10.1002/ijc.32740
pubmed: 31618444
Inwald EC, Ortmann O, Zeman F et al (2014) Guideline concordant therapy prolongs survival in HER2-positive breast cancer patients: results from a large population-based cohort of a cancer registry. Biomed Res Int 2014:137304. https://doi.org/10.1155/2014/137304
doi: 10.1155/2014/137304
pubmed: 24779005
pmcid: 3977430
Kommission Uterus der Arbeitsgemeinschaft Gynäkologische Onkologie e.V. in der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe e.V. sowie in der Deutschen Krebsgesellschaft e. V (2010) AWMF online - Leitlinie Onkologie/Gynäkologie: Endometriumkarzinom. https://www.awmf.org/uploads/tx_szleitlinien/032-034l_S2k_Endometriumkarzinom_01.pdf . Accessed 18 Apr 2022
Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe,, AWMF) (2018) S3-Leitlinie Diagnostik, Therapie und Nachsorge der Patientinnen mit Endometriumkarzinom. https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Endometriumkarzinom/LL_Endometriumkarzinom_Langversion_1.0.pdf . Accessed 18 Apr 2022
Mould T, Brand A, Nijman H et al (2018) STATEC: a randomised trial of non-selective versus selective adjuvant therapy in high risk apparent stage 1 endometrial cancer. JCO 36:TPS5615. https://doi.org/10.1200/JCO.2018.36.15_suppl.TPS5615
doi: 10.1200/JCO.2018.36.15_suppl.TPS5615
National Comprehensive Cancer Network NCCN (2022) Clinical Practice Guidelines in Oncology (NCCN Guidelines
Randall ME, Filiaci V, McMeekin DS et al (2019) Phase III trial: adjuvant pelvic radiation therapy versus vaginal brachytherapy plus paclitaxel/carboplatin in high-intermediate and high-risk early stage endometrial cancer. J Clin Oncol 37:1810–1818. https://doi.org/10.1200/JCO.18.01575
doi: 10.1200/JCO.18.01575
pubmed: 30995174
pmcid: 6804858
Scharl S, Papathemelis T, Kronberger K et al (2018) Does post-operative radiochemotherapy improve survival in high-grade endometrial cancer patients? Results of a population-based cohort analysis of a cancer registry. Arch Gynecol Obstet 297:1245–1253. https://doi.org/10.1007/s00404-018-4708-6
doi: 10.1007/s00404-018-4708-6
pubmed: 29417286
Schwentner L, Wolters R, Koretz K et al (2012) Triple-negative breast cancer: the impact of guideline-adherent adjuvant treatment on survival—a retrospective multi-centre cohort study. Breast Cancer Res Treat 132:1073–1080. https://doi.org/10.1007/s10549-011-1935-y
doi: 10.1007/s10549-011-1935-y
pubmed: 22205141
Taubenhansl C, Ortmann O, Gerken M et al (2020) Guideline-concordant chemotherapy in patients with hormone receptor-positive and node-positive, early breast cancer leads to better overall and metastases-free survival with limited benefit in elderly patients. Arch Gynecol Obstet 301:573–583. https://doi.org/10.1007/s00404-019-05387-3
doi: 10.1007/s00404-019-05387-3
pubmed: 31749031
Wimmer T, Ortmann O, Gerken M et al (2019) Adherence to guidelines and benefit of adjuvant radiotherapy in patients with invasive breast cancer: results from a large population-based cohort study of a cancer registry. Arch Gynecol Obstet 299:1131–1140. https://doi.org/10.1007/s00404-018-5030-z
doi: 10.1007/s00404-018-5030-z
pubmed: 30607594
Wöckel A, Varga D, Atassi Z et al (2010) Impact of guideline conformity on breast cancer therapy: results of a 13-year retrospective cohort study. Onkologie 33:21–28. https://doi.org/10.1159/000264617
doi: 10.1159/000264617
pubmed: 20164658
Wolters R, Wischhusen J, Stüber T et al (2015) Guidelines are advantageous, though not essential for improved survival among breast cancer patients. Breast Cancer Res Treat 152:357–366. https://doi.org/10.1007/s10549-015-3484-2
doi: 10.1007/s10549-015-3484-2
pubmed: 26105798