Daily Practice Management of pT1a-b pN0 Breast Carcinoma: A Prospective French ODISSEE Cohort Study

Autor: Philippe Liegeois, Laurent Puyuelo, Hanane Attar-Rabia, Yazid Belkacemi, Monique Cohen, Magali Lacroix-Triki, Jean-Philippe Suchaud, Chahinez Benkanoun, Mohammed Zouai, Marie-Pierre Chauvet, Gilles Houvenaeghel, Florence Dalenc, Frédérique Penault-Llorca, Jean-Marc Piat, Joseph Gligorov, Nina Radosevic-Robin
Přispěvatelé: Departement /u563 : Oncogenèse, Signalisation et Innovation thérapeutique, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut Claudius Regaud, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), La Casamance, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Département de Biologie et de Pathologie, Institut Claudius Regaud, Equipe de recherche sur les traitements individualisés des cancers (ERTICa), Université d'Auvergne - Clermont-Ferrand I (UdA), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de radiothérapie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut Claudius Regaud, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Rok vydání: 2016
Předmět:
0301 basic medicine
Oncology
Cancer Research
Receptor
ErbB-2
health care facilities
manpower
and services
medicine.medical_treatment
0302 clinical medicine
Trastuzumab
Prospective Studies
Prospective cohort study
health care economics and organizations
Aged
80 and over
Conservative surgery
Sentinel node
Middle Aged
Prognosis
3. Good health
Treatment Outcome
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Female
France
medicine.drug
Cohort study
Endocrine therapy
Adult
medicine.medical_specialty
Antineoplastic Agents
Hormonal
education
Breast cancer subtypes
[SDV.CAN]Life Sciences [q-bio]/Cancer
Breast Neoplasms
Disease-Free Survival
03 medical and health sciences
Young Adult
Breast cancer
Internal medicine
medicine
Biomarkers
Tumor
Humans
Aged
Neoplasm Staging
Radiotherapy
business.industry
Estrogen Receptor alpha
Cancer
Adjuvant treatment
medicine.disease
Radiation therapy
030104 developmental biology
Radiotherapy
Adjuvant
Hormone therapy
Self Report
Neoplasm Grading
Neoplasm Recurrence
Local
business
Follow-Up Studies
Zdroj: Clinical Breast Cancer
Clinical Breast Cancer, Elsevier, 2017, 17 (2), pp.107-116. ⟨10.1016/j.clbc.2016.08.007⟩
Clinical Breast Cancer, 2017, 17 (2), pp.107-116. ⟨10.1016/j.clbc.2016.08.007⟩
ISSN: 1938-0666
1526-8209
Popis: Background Most breast cancer (BC) tumors ≤10 mm have an excellent prognosis. The subgroups with a higher risk for distant recurrence requiring adjuvant systemic therapy are not precisely defined in current international guidelines. Patients and Methods The O BSERVATOIRE D ES PET I TS CANCER S DU SE IN H E R2 +/− (ODISSEE) study was a prospective, multicenter, cohort study that aimed to describe the daily adjuvant management and outcome of 616 patients with unifocal, invasive pT1a-b pN0 nonmetastatic BC who underwent surgery. Results At the time of diagnosis, the median age of patients was 61 years. Tumor was detected on imaging or during a screening program in 397 patients (64.6%). Most patients (96%) underwent conservative surgery with sentinel node biopsy (89%), completed with axillary lymph node dissection in 15%. At inclusion, 82% of tumors were pT1b, 73% were pN0 (i−), 53% were Scarff–Bloom–Richardson Grade I, 91% were estrogen receptor (ER)-positive, 5% overexpressed/amplified HER2, and 5% were triple negative (TNBC). Adjuvant treatments were radiotherapy (95%), hormone therapy (82%), chemotherapy (7%), and trastuzumab (3.5%). In patients with TNBC and HER2-positive BC, chemotherapy and trastuzumab (if needed) were administered in 45% and 68%, respectively. After 5 years of follow-up, 7 patients had contralateral BC, 7 had locoregional recurrence, and 1 had distant metastasis. At 5 years, overall survival, disease-free survival, and recurrence-free survival were: 98.4% (96.9%-99.1%), 94.7% (92.4%-96.3%), and 97.1% (95.2%-98.2%), respectively. Conclusion This prospective cohort study showed that in France, the routine practice in pT1a-b pN0 breast cancers follows international standard guidelines for practice including conservative surgery followed by radiotherapy and endocrine therapy for ER-positive patients. Adjuvant chemotherapy with or without trastuzumab was used but their benefit in breast cancer of ≤10 mm remains controversial.
Databáze: OpenAIRE
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