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Trends in breast cancer treatment in Korea and impact of compliance with consensus recommendations on survival

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dc.contributor.authorYun, Young Ho-
dc.contributor.authorPark, Sang Min-
dc.contributor.authorNoh, Dong Young-
dc.contributor.authorNam, Seok Jin-
dc.contributor.authorAhn, Se Hyun-
dc.contributor.authorPark, Byeong Woo-
dc.contributor.authorLee, Eun Sook-
dc.date.accessioned2009-11-27T05:07:38Z-
dc.date.available2009-11-27T05:07:38Z-
dc.date.issued2007-11-01-
dc.identifier.citationBreast Cancer Res Treat. 2007 Dec;106(2):245-53. Epub 2007 Feb 15en
dc.identifier.issn0167-6806 (Print)-
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17972176-
dc.identifier.urihttps://hdl.handle.net/10371/16603-
dc.description.abstractAlthough some studies suggest that conformity with consensus recommendations for breast cancer therapy is associated with increased survival, the data are not clear. We identified patients in four hospital-based breast cancer registries in Korea who had undergone primary curative surgery (stage 0-III) from 1993 through 2002 (n = 8,407). We collected demographic and clinical characteristics such as age, stage, treatment, and hormone receptor status. We gathered 1993-2004 mortality data by linkage to the National Statistical Office. During the follow-up period of 43,145 person-years (mean, 5.13 years), we identified 899 deceased cases. We used the standard Poisson regression model to estimate the hazard ratio (HR) for survival in relation to conformity with guidelines for chemo-, hormone, and locoregional therapy. Guideline compliance for systemic therapy increased from 24.0% in 1993 to 83.8% in 2002. Among mastectomy patients with <4 positive lymph nodes and tumors <5 cm, post-mastectomy radiotherapy was associated with poor survival (HR 2.07; 95% CI: 1.53-2.81). Tamoxifen use was associated with better survival among patients with hormone receptor-positive tumors (HR 0.57; 95% CI: 0.45-0.73) and with poorer survival among hormone receptor-negative patients who had affected nodes (HR 1.58; 95% CI: 1.01-2.44). Relative to conformity, non-conformity with both chemo- and hormone therapy guidelines was associated with a 76% higher risk of death. Compliance with consensus recommendations for chemo- and hormone therapy is significantly associated with better survival. Overuse of post-mastectomy radiotherapy and tamoxifen beyond the consensus recommendations may be harmful.en
dc.language.isoenen
dc.publisherSpringer Verlagen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectAntineoplastic Agents/therapeutic useen
dc.subjectBreast Neoplasms/drug therapy/radiotherapy/surgery/*therapyen
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectCombined Modality Therapyen
dc.subjectConsensus Development Conferences as Topicen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectInfanten
dc.subjectInfant, Newbornen
dc.subjectMastectomyen
dc.subjectMiddle Ageden
dc.subjectPrognosisen
dc.subjectSurvival Rateen
dc.subjectGuideline Adherence-
dc.subjectPractice Guidelines as Topic-
dc.titleTrends in breast cancer treatment in Korea and impact of compliance with consensus recommendations on survivalen
dc.typeArticleen
dc.contributor.AlternativeAuthor윤영호-
dc.contributor.AlternativeAuthor박상민-
dc.contributor.AlternativeAuthor노동영-
dc.contributor.AlternativeAuthor남석진-
dc.contributor.AlternativeAuthor안세현-
dc.contributor.AlternativeAuthor박병우-
dc.contributor.AlternativeAuthor이은숙-
dc.identifier.doi10.1007/s10549-006-9490-7-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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