Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem.

BACKGROUND/AIM: In this retrospective study, we compared breast cancer patients treated with and without mistletoe lectin I (ML-I) in addition to standard breast cancer treatment in order to determine a possible effect of this complementary treatment. PATIENTS AND METHODS: This study included 18,528 patients with invasive breast cancer. Data on additional ML-I treatments were reported for 164 patients. We developed a "similar case" method with a distance measure retrieved from the beta variable in Cox regression to compare these patients, after stage adjustment, with their non-ML-1 treated counterparts in order to answer three hypotheses concerning overall survival, recurrence free survival and life quality. RESULTS: Raw data analysis of an additional ML-I treatment yielded a worse outcome (p=0.02) for patients with ML treatment, possibly due to a bias inherent in the ML-I-treated patients. Using the "similar case" method (a case-based reasoning approach) we could not confirm this harm for patients using ML-I. Analysis of life quality data did not demonstrate reliable differences between patients treated with ML-I treatment and those without proven ML-I treatment. CONCLUSION: Based on a "similar case" model we did not observe any differences in the overall survival (OS), recurrence-free survival (RFS), and quality of life data between breast cancer patients with standard treatment and those who in addition to standard treatment received ML-I treatment.

Tubular breast cancer. A retrospective study.

BACKGROUND: The well-characterized tubular-type of breast tumors is classified as low-risk breast cancer. PATIENTS AND METHODS: We report on the results of a retrospective analysis on clinical and biological features of 248 tubular breast tumors including follow-up and treatment data from two German series of 21,065 breast cancer cases. The majority of tumors were stage I or stage II, ER- and PR-positive and c-erbB2-negative with a 5-year survival-rate of 96.3%. 51.3% of patients received hormonal treatment, 75.5% had post-operative radiotherapy and 11.8% were treated with a chemotherapeutical regimen. CONCLUSION: Our retrospective analysis showed no treatment benefit for either anti-hormonal or chemotherapeutical regimens. Post-operative radiotherapy, however, improved the survival rate of patients with tubular carcinoma (log-rank=5, p=0.025). Our data suggest that post-operative radiotherapy is an important treatment to prolong survival for patients suffering from tubular breast cancer.

[Benchmarking: how to measure outcome quality at the comprehensive oncology centre in Stuttgart]. / Benchmarking der Ergebnisqualität am Onkologischen Schwerpunkt Stuttgart.

BACKGROUND: Quality-controlled documentation and evaluation of long-term course of disease is essential for measuring the outcome quality in the care of cancer patients. This project, based on the ongoing clinical cancer registry of the Comprehensive Oncology Centre (COC) Stuttgart, was aimed to integrate a long-term follow-up documentation and to compare outcome quality between centres of the OCC. METHODS: In a prospective, non-randomised, multi-centred, registry-based cohort study overall survival, disease free survival and quality of life were evaluated as indicators of outcome quality. The study included all patients suffering from breast, colon or rectum cancer, who were treated with curative intent in one of the centres of the OCC between Sep 30, 2003, and Dec 31, 2008. Cox regressions were used for the statistical evaluation of differences between centres. RESULTS: Patients suffering from breast cancer (n=3,213), colon cancer (n=1,216) and rectum cancer (n=847) were eligible for the analysis. They were treated in 10 of 13 centres of the OCC. Statistically significant differences in the overall survival could be demonstrated between centres. DISCUSSION: This project initiated a regular comparative evaluation of the outcome quality and showed that there are statistically significant differences between centres. Based on these findings, the benchmarking process will have to be further developed and elaborated.