The Impact of Chemotherapy Prescription on Long-Term Survival Outcomes in Early-Stage Invasive Lobular Carcinoma - A Systematic Review and Meta-Analysis.
Clin Breast Cancer
; 22(8): e843-e849, 2022 12.
Article
en En
| MEDLINE
| ID: mdl-36229335
ABSTRACT
INTRODUCTION:
Invasive lobular carcinoma (ILCs) are typically endocrine responsive breast cancers which respond poorly to chemotherapy. The long-term survival advantage of prescribing chemotherapy in such cases remains unclear. To perform a systematic review and meta-analysis assessing, the impact of prescribing chemotherapy in such patients on long-term disease-free (DFS) and overall (OS) survival outcomes.METHODS:
A systematic review and meta-analysis was performed in accordance with the PRISMA guidelines. Ten-year DFS and OS were pooled as odds ratios (ORs) with 95% confidence intervals (CI) using the Mantel-Haenszel method. Time-to-effect modelling was performed using the generic inverse variance method.RESULTS:
Overall, 9 studies including 28,218 patients were included. The mean follow-up was 74 months (range 0-150 months) and mean age was 60 years (range 22-90 years). Of these, 34.7% received chemotherapy (9,797/28,218) and 66.3% did not receive chemotherapy (18,421/28,218). Chemotherapy prescription failed to improve 10-year DFS (OR 0.89, 95% CI 0.65-1.23) and OS (OR 0.92, 95% CI 0.72-1.18). When using time-to-effect modelling, chemotherapy prescription failed to improve DFS (hazard ratio (HR) 1.01, 95% CI 0.78-1.31) and OS (HR 1.07, 95% CI 0.89-1.27, I2= 67%).CONCLUSION:
This meta-analysis illustrates no long-term survival advantage associated with chemotherapy prescription in the setting of early-stage ILC. In the absence of well-designed, prospective clinical trials evaluating the impact of chemotherapy on long-term outcomes in ILC, these results should be considered by the multidisciplinary team when deciding on the value of systemic chemotherapy prescription in ILC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
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Carcinoma Lobular
Tipo de estudio:
Guideline
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Female
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Humans
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Middle aged
Idioma:
En
Revista:
Clin Breast Cancer
Asunto de la revista:
NEOPLASIAS
Año:
2022
Tipo del documento:
Article