TY - JOUR
T1 - 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
AU - van der Plas-Krijgsman, Willeke G.
AU - Morgan, Jenna L.
AU - de Glas, Nienke A.
AU - de Boer, Anna Z.
AU - Martin, Charlene L.
AU - Holmes, Geoffrey R.
AU - Ward, Susan E.
AU - Chater, Tim
AU - Reed, Malcolm W.
AU - Merkus, Jos W.S.
AU - van Dalen, Thijs
AU - Vulink, Annelie J.E.
AU - van Gerven, Leander
AU - Guicherit, Onno R.
AU - Linthorst-Niers, Eugenie
AU - Lans, Titia E.
AU - Bastiaannet, Esther
AU - Portielje, Johanneke E.A.
AU - Liefers, Gerrit Jan
AU - Wyld, Lynda
N1 - Funding Information:
Age Gap: The UK National Institute for Health Research (NIHR). Grant reference number RP-PG-1209-10071. Climb: KWF Kankerbestrijding. Grant reference number: UL 2011–5263.This paper presents independent research funded by the National Institute for Health Research under its Programme Grants for Applied Research Programme (grant reference number RP-PG-1209-10071). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Funding Information:
This paper presents independent research funded by the National Institute for Health Research under its Programme Grants for Applied Research Programme (grant reference number RP-PG-1209-10071 ). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2022 The Authors
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - 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.
AB - 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.
KW - Breast cancer
KW - Geriatric oncology
KW - Older patients
KW - Survival
KW - Prospective Studies
KW - Humans
KW - United Kingdom/epidemiology
KW - Aged, 80 and over
KW - Female
KW - Aged
KW - Chemotherapy, Adjuvant
KW - Netherlands/epidemiology
KW - Breast Neoplasms/drug therapy
UR - https://www.scopus.com/pages/publications/85123175784
U2 - 10.1016/j.ejca.2021.12.018
DO - 10.1016/j.ejca.2021.12.018
M3 - Article
C2 - 35081505
AN - SCOPUS:85123175784
SN - 0959-8049
VL - 163
SP - 189
EP - 199
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -