Disease-free survival does not differ according to fertility preservation technique for young women with breast cancer
To study whether fertility preservation strategies using ovarian stimulation or without using it impact long-term disease-free survival of patients with breast cancer. Retrospective bicentric cohort study. Two university hospitals. In this study, 740 women with breast cancer, aged 18–43 years, who r...
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| Veröffentlicht in: | Fertility and sterility 2023-03, Vol.119 (3), p.465-473 |
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| creator | Sonigo, Charlotte Amsellem, Noémi Mayeur, Anne Laup, Laetitia Pistilli, Barbara Delaloge, Suzette Eustache, Florence Sifer, Christophe Rakrouki, Sophia Benoit, Alexandra Peigné, Maeliss Grynberg, Michael |
| description | To study whether fertility preservation strategies using ovarian stimulation or without using it impact long-term disease-free survival of patients with breast cancer.
Retrospective bicentric cohort study.
Two university hospitals.
In this study, 740 women with breast cancer, aged 18–43 years, who received primary fertility preservation between 2013 and 2019 after a diagnosis of localized breast cancer were included.
Overall, 328 patients underwent at least 1 ovarian stimulation cycle (STIM group) and 412 had a technique without hormonal administration (no STIM group).
Disease-free survival and overall survival up to May 2021 were compared between the 2 groups by log-rank test. Cox proportional-hazard regression model was used for multivariable analyses.
Out of the 740 women who underwent fertility preservation, follow-up data were available for 269 women in the STIM group (82%) and 330 (80%) in the no STIM group. Kaplan-Meier estimates of disease-free survival at 4 years were 87.9% (82.8%–92.2%) and 83.1% (78.4%–87.3%) in the STIM and no STIM groups, respectively. After adjustment on prognostic parameters, no significant difference in breast cancer recurrence rate was observed between the STIM and no STIM groups (hazard ratios, 0.83 [0.64–1.08]). Kaplan-Meier estimate of overall survival at 4 years was 97.6% (95.3%–99.2%) and 93.6% (90.9%–95.9%) in the STIM and no STIM groups, respectively. Overall survival was higher in the STIM group than no STIM group (log-rank test). After adjustment on prognostic parameters, the risk of death remained significantly lower in the STIM group (Hazard Ratio, 0.55 [0.35–0.85]).
In our cohort, STIM for fertility preservation in breast cancer did not significantly impact disease-free survival but was associated with higher overall survival. The disease-free survival and overall survival of young patients with breast cancer were not impacted by fertility preservation techniques irrespective of the timing of chemotherapy (neoadjuvant or adjuvant) and the use of ovarian stimulation. Nevertheless, because death and recurrence were rare events, these results should be taken with caution.
El periodo libre de enfermedad no difiere según la técnica de preservación de la fertilidad en mujeres jóvenes con cáncer de mama.
Estudiar si las estrategias de preservación de la fertilidad con estimulación ovárica o sin ella influyen en la supervivencia sin enfermedad a largo plazo de las pacientes con cáncer de mama.
Estudio retrospectivo de |
| doi_str_mv | 10.1016/j.fertnstert.2022.11.020 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2771085342</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0015028222020489</els_id><sourcerecordid>2771085342</sourcerecordid><originalsourceid>FETCH-LOGICAL-c374t-cf9a2b12961fd0891a10a0d34bd84d3f9589ea89f2426971626eb58366653983</originalsourceid><addsrcrecordid>eNqFkMtu3CAUQFGVqpmk_YWKZTZ2eNgYls2rrRSpm-wRhkvDyGOmgB3N35fRpMmyG9icy-EehDAlLSVUXG9bD6nMudSzZYSxltKWMPIBbWjfi6YXPT9DG0Jo3xAm2Tm6yHlLCBF0YJ_QORfdwAVRG7TehQwmQ-MTAM5LWsNqJuwiZDzHgl3wVYWNtTG5MP_GJeKjO0yhHPA-QYa0mhLijAvY5zn8WQD7mPAhLpV-iTuY8Usoz3hM1VOwNbOF9Bl99GbK8OX1vkRPD_dPtz-ax1_ff95-e2wsH7rSWK8MGylTgnpHpKKGEkMc70YnO8e96qUCI5VnHRNqoIIJGHvJhagBlOSX6Or07D7F-rFc9C5kC9NkZohL1mwYKJE971hF5Qm1KeacwOt9CjuTDpoSfYyut_o9uj5G15TqGr2Ofn21LOMO3Nvgv8oVuDkBUFddAySdbYDawYUEtmgXw_8tfwEorpp1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2771085342</pqid></control><display><type>article</type><title>Disease-free survival does not differ according to fertility preservation technique for young women with breast cancer</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Sonigo, Charlotte ; Amsellem, Noémi ; Mayeur, Anne ; Laup, Laetitia ; Pistilli, Barbara ; Delaloge, Suzette ; Eustache, Florence ; Sifer, Christophe ; Rakrouki, Sophia ; Benoit, Alexandra ; Peigné, Maeliss ; Grynberg, Michael</creator><creatorcontrib>Sonigo, Charlotte ; Amsellem, Noémi ; Mayeur, Anne ; Laup, Laetitia ; Pistilli, Barbara ; Delaloge, Suzette ; Eustache, Florence ; Sifer, Christophe ; Rakrouki, Sophia ; Benoit, Alexandra ; Peigné, Maeliss ; Grynberg, Michael</creatorcontrib><description>To study whether fertility preservation strategies using ovarian stimulation or without using it impact long-term disease-free survival of patients with breast cancer.
Retrospective bicentric cohort study.
Two university hospitals.
In this study, 740 women with breast cancer, aged 18–43 years, who received primary fertility preservation between 2013 and 2019 after a diagnosis of localized breast cancer were included.
Overall, 328 patients underwent at least 1 ovarian stimulation cycle (STIM group) and 412 had a technique without hormonal administration (no STIM group).
Disease-free survival and overall survival up to May 2021 were compared between the 2 groups by log-rank test. Cox proportional-hazard regression model was used for multivariable analyses.
Out of the 740 women who underwent fertility preservation, follow-up data were available for 269 women in the STIM group (82%) and 330 (80%) in the no STIM group. Kaplan-Meier estimates of disease-free survival at 4 years were 87.9% (82.8%–92.2%) and 83.1% (78.4%–87.3%) in the STIM and no STIM groups, respectively. After adjustment on prognostic parameters, no significant difference in breast cancer recurrence rate was observed between the STIM and no STIM groups (hazard ratios, 0.83 [0.64–1.08]). Kaplan-Meier estimate of overall survival at 4 years was 97.6% (95.3%–99.2%) and 93.6% (90.9%–95.9%) in the STIM and no STIM groups, respectively. Overall survival was higher in the STIM group than no STIM group (log-rank test). After adjustment on prognostic parameters, the risk of death remained significantly lower in the STIM group (Hazard Ratio, 0.55 [0.35–0.85]).
In our cohort, STIM for fertility preservation in breast cancer did not significantly impact disease-free survival but was associated with higher overall survival. The disease-free survival and overall survival of young patients with breast cancer were not impacted by fertility preservation techniques irrespective of the timing of chemotherapy (neoadjuvant or adjuvant) and the use of ovarian stimulation. Nevertheless, because death and recurrence were rare events, these results should be taken with caution.
El periodo libre de enfermedad no difiere según la técnica de preservación de la fertilidad en mujeres jóvenes con cáncer de mama.
Estudiar si las estrategias de preservación de la fertilidad con estimulación ovárica o sin ella influyen en la supervivencia sin enfermedad a largo plazo de las pacientes con cáncer de mama.
Estudio retrospectivo de cohortes bicéntrico.
Dos hospitales universitarios.
En este estudio, se incluyeron 740 mujeres con cáncer de mama, de entre 18 y 43 años, que realizaron inicialmente preservación de la fertilidad entre 2013 y 2019 tras un diagnóstico de cáncer de mama localizado.
En total, 328 pacientes se sometieron al menos a 1 ciclo de estimulación ovárica (grupo STIM) y 412 a una técnica sin administración hormonal (grupo no STIM).
El periodo libre de enfermedad y la supervivencia global hasta mayo de 2021, se compararon entre los 2 grupos mediante logranktest. Para los análisis multivariables se utilizó el modelo de regresión de riesgos proporcionales de Cox.
De las 740 mujeres que se sometieron a preservación de la fertilidad, se dispuso de datos de seguimiento de 269 mujeres del grupo STIM (82%) y 330 (80%) del grupo sin STIM. Las estimaciones de Kaplan-Meier de la supervivencia libre de enfermedad a los 4 años fueron del 87,9% (82,8%-92,2%) y del 83,1% (78,4%-87,3%) en los grupos STIM y no STIM, respectivamente. Tras ajustar los parámetros pronósticos, no se observaron diferencias significativas en la tasa de recurrencia del cáncer de mama entre los grupos con y sin STIM (cocientes de riesgo, 0,83 [0,64-1,08]). La estimación de Kaplan-Meier de la supervivencia global a los 4 años fue del 97,6% (95,3%-99,2%) y del 93,6% (90,9%-95,9%) en los grupos con y sin STIM, respectivamente. La supervivencia global fue mayor en el grupo con STIM que en el grupo sin STIM (log-rank test). Tras el ajuste de los parámetros pronósticos, el riesgo de muerte siguió siendo significativamente inferior en el grupo STIM (cociente de riesgo, 0,55 [0,35-0,85]).
En nuestra cohorte, la STIM para la preservación de la fertilidad en el cáncer de mama no tuvo un impacto significativo en la supervivencia libre de enfermedad, pero se asoció con una mayor supervivencia global. La supervivencia libre de enfermedad y la supervivencia global de las pacientes jóvenes con cáncer de mama no se vieron afectadas por las técnicas de preservación de la fertilidad, independientemente del momento de la quimioterapia (neoadyuvante o adyuvante) y del uso de la estimulación ovárica. No obstante, dado que la muerte y la recidiva fueron eventos poco frecuentes, estos resultados deben tomarse con cautela.</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2022.11.020</identifier><identifier>PMID: 36473609</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Breast cancer ; Breast Neoplasms - drug therapy ; Cohort Studies ; controlled ovarian hyperstimulation ; Disease-Free Survival ; Female ; fertility preservation ; Fertility Preservation - methods ; Humans ; in vitro maturation ; Neoplasm Recurrence, Local ; Retrospective Studies</subject><ispartof>Fertility and sterility, 2023-03, Vol.119 (3), p.465-473</ispartof><rights>2022 American Society for Reproductive Medicine</rights><rights>Copyright © 2022 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-cf9a2b12961fd0891a10a0d34bd84d3f9589ea89f2426971626eb58366653983</citedby><cites>FETCH-LOGICAL-c374t-cf9a2b12961fd0891a10a0d34bd84d3f9589ea89f2426971626eb58366653983</cites><orcidid>0000-0002-0875-1592</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0015028222020489$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36473609$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sonigo, Charlotte</creatorcontrib><creatorcontrib>Amsellem, Noémi</creatorcontrib><creatorcontrib>Mayeur, Anne</creatorcontrib><creatorcontrib>Laup, Laetitia</creatorcontrib><creatorcontrib>Pistilli, Barbara</creatorcontrib><creatorcontrib>Delaloge, Suzette</creatorcontrib><creatorcontrib>Eustache, Florence</creatorcontrib><creatorcontrib>Sifer, Christophe</creatorcontrib><creatorcontrib>Rakrouki, Sophia</creatorcontrib><creatorcontrib>Benoit, Alexandra</creatorcontrib><creatorcontrib>Peigné, Maeliss</creatorcontrib><creatorcontrib>Grynberg, Michael</creatorcontrib><title>Disease-free survival does not differ according to fertility preservation technique for young women with breast cancer</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>To study whether fertility preservation strategies using ovarian stimulation or without using it impact long-term disease-free survival of patients with breast cancer.
Retrospective bicentric cohort study.
Two university hospitals.
In this study, 740 women with breast cancer, aged 18–43 years, who received primary fertility preservation between 2013 and 2019 after a diagnosis of localized breast cancer were included.
Overall, 328 patients underwent at least 1 ovarian stimulation cycle (STIM group) and 412 had a technique without hormonal administration (no STIM group).
Disease-free survival and overall survival up to May 2021 were compared between the 2 groups by log-rank test. Cox proportional-hazard regression model was used for multivariable analyses.
Out of the 740 women who underwent fertility preservation, follow-up data were available for 269 women in the STIM group (82%) and 330 (80%) in the no STIM group. Kaplan-Meier estimates of disease-free survival at 4 years were 87.9% (82.8%–92.2%) and 83.1% (78.4%–87.3%) in the STIM and no STIM groups, respectively. After adjustment on prognostic parameters, no significant difference in breast cancer recurrence rate was observed between the STIM and no STIM groups (hazard ratios, 0.83 [0.64–1.08]). Kaplan-Meier estimate of overall survival at 4 years was 97.6% (95.3%–99.2%) and 93.6% (90.9%–95.9%) in the STIM and no STIM groups, respectively. Overall survival was higher in the STIM group than no STIM group (log-rank test). After adjustment on prognostic parameters, the risk of death remained significantly lower in the STIM group (Hazard Ratio, 0.55 [0.35–0.85]).
In our cohort, STIM for fertility preservation in breast cancer did not significantly impact disease-free survival but was associated with higher overall survival. The disease-free survival and overall survival of young patients with breast cancer were not impacted by fertility preservation techniques irrespective of the timing of chemotherapy (neoadjuvant or adjuvant) and the use of ovarian stimulation. Nevertheless, because death and recurrence were rare events, these results should be taken with caution.
El periodo libre de enfermedad no difiere según la técnica de preservación de la fertilidad en mujeres jóvenes con cáncer de mama.
Estudiar si las estrategias de preservación de la fertilidad con estimulación ovárica o sin ella influyen en la supervivencia sin enfermedad a largo plazo de las pacientes con cáncer de mama.
Estudio retrospectivo de cohortes bicéntrico.
Dos hospitales universitarios.
En este estudio, se incluyeron 740 mujeres con cáncer de mama, de entre 18 y 43 años, que realizaron inicialmente preservación de la fertilidad entre 2013 y 2019 tras un diagnóstico de cáncer de mama localizado.
En total, 328 pacientes se sometieron al menos a 1 ciclo de estimulación ovárica (grupo STIM) y 412 a una técnica sin administración hormonal (grupo no STIM).
El periodo libre de enfermedad y la supervivencia global hasta mayo de 2021, se compararon entre los 2 grupos mediante logranktest. Para los análisis multivariables se utilizó el modelo de regresión de riesgos proporcionales de Cox.
De las 740 mujeres que se sometieron a preservación de la fertilidad, se dispuso de datos de seguimiento de 269 mujeres del grupo STIM (82%) y 330 (80%) del grupo sin STIM. Las estimaciones de Kaplan-Meier de la supervivencia libre de enfermedad a los 4 años fueron del 87,9% (82,8%-92,2%) y del 83,1% (78,4%-87,3%) en los grupos STIM y no STIM, respectivamente. Tras ajustar los parámetros pronósticos, no se observaron diferencias significativas en la tasa de recurrencia del cáncer de mama entre los grupos con y sin STIM (cocientes de riesgo, 0,83 [0,64-1,08]). La estimación de Kaplan-Meier de la supervivencia global a los 4 años fue del 97,6% (95,3%-99,2%) y del 93,6% (90,9%-95,9%) en los grupos con y sin STIM, respectivamente. La supervivencia global fue mayor en el grupo con STIM que en el grupo sin STIM (log-rank test). Tras el ajuste de los parámetros pronósticos, el riesgo de muerte siguió siendo significativamente inferior en el grupo STIM (cociente de riesgo, 0,55 [0,35-0,85]).
En nuestra cohorte, la STIM para la preservación de la fertilidad en el cáncer de mama no tuvo un impacto significativo en la supervivencia libre de enfermedad, pero se asoció con una mayor supervivencia global. La supervivencia libre de enfermedad y la supervivencia global de las pacientes jóvenes con cáncer de mama no se vieron afectadas por las técnicas de preservación de la fertilidad, independientemente del momento de la quimioterapia (neoadyuvante o adyuvante) y del uso de la estimulación ovárica. No obstante, dado que la muerte y la recidiva fueron eventos poco frecuentes, estos resultados deben tomarse con cautela.</description><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Cohort Studies</subject><subject>controlled ovarian hyperstimulation</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>fertility preservation</subject><subject>Fertility Preservation - methods</subject><subject>Humans</subject><subject>in vitro maturation</subject><subject>Neoplasm Recurrence, Local</subject><subject>Retrospective Studies</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtu3CAUQFGVqpmk_YWKZTZ2eNgYls2rrRSpm-wRhkvDyGOmgB3N35fRpMmyG9icy-EehDAlLSVUXG9bD6nMudSzZYSxltKWMPIBbWjfi6YXPT9DG0Jo3xAm2Tm6yHlLCBF0YJ_QORfdwAVRG7TehQwmQ-MTAM5LWsNqJuwiZDzHgl3wVYWNtTG5MP_GJeKjO0yhHPA-QYa0mhLijAvY5zn8WQD7mPAhLpV-iTuY8Usoz3hM1VOwNbOF9Bl99GbK8OX1vkRPD_dPtz-ax1_ff95-e2wsH7rSWK8MGylTgnpHpKKGEkMc70YnO8e96qUCI5VnHRNqoIIJGHvJhagBlOSX6Or07D7F-rFc9C5kC9NkZohL1mwYKJE971hF5Qm1KeacwOt9CjuTDpoSfYyut_o9uj5G15TqGr2Ofn21LOMO3Nvgv8oVuDkBUFddAySdbYDawYUEtmgXw_8tfwEorpp1</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Sonigo, Charlotte</creator><creator>Amsellem, Noémi</creator><creator>Mayeur, Anne</creator><creator>Laup, Laetitia</creator><creator>Pistilli, Barbara</creator><creator>Delaloge, Suzette</creator><creator>Eustache, Florence</creator><creator>Sifer, Christophe</creator><creator>Rakrouki, Sophia</creator><creator>Benoit, Alexandra</creator><creator>Peigné, Maeliss</creator><creator>Grynberg, Michael</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0875-1592</orcidid></search><sort><creationdate>202303</creationdate><title>Disease-free survival does not differ according to fertility preservation technique for young women with breast cancer</title><author>Sonigo, Charlotte ; Amsellem, Noémi ; Mayeur, Anne ; Laup, Laetitia ; Pistilli, Barbara ; Delaloge, Suzette ; Eustache, Florence ; Sifer, Christophe ; Rakrouki, Sophia ; Benoit, Alexandra ; Peigné, Maeliss ; Grynberg, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-cf9a2b12961fd0891a10a0d34bd84d3f9589ea89f2426971626eb58366653983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Cohort Studies</topic><topic>controlled ovarian hyperstimulation</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>fertility preservation</topic><topic>Fertility Preservation - methods</topic><topic>Humans</topic><topic>in vitro maturation</topic><topic>Neoplasm Recurrence, Local</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sonigo, Charlotte</creatorcontrib><creatorcontrib>Amsellem, Noémi</creatorcontrib><creatorcontrib>Mayeur, Anne</creatorcontrib><creatorcontrib>Laup, Laetitia</creatorcontrib><creatorcontrib>Pistilli, Barbara</creatorcontrib><creatorcontrib>Delaloge, Suzette</creatorcontrib><creatorcontrib>Eustache, Florence</creatorcontrib><creatorcontrib>Sifer, Christophe</creatorcontrib><creatorcontrib>Rakrouki, Sophia</creatorcontrib><creatorcontrib>Benoit, Alexandra</creatorcontrib><creatorcontrib>Peigné, Maeliss</creatorcontrib><creatorcontrib>Grynberg, Michael</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sonigo, Charlotte</au><au>Amsellem, Noémi</au><au>Mayeur, Anne</au><au>Laup, Laetitia</au><au>Pistilli, Barbara</au><au>Delaloge, Suzette</au><au>Eustache, Florence</au><au>Sifer, Christophe</au><au>Rakrouki, Sophia</au><au>Benoit, Alexandra</au><au>Peigné, Maeliss</au><au>Grynberg, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disease-free survival does not differ according to fertility preservation technique for young women with breast cancer</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2023-03</date><risdate>2023</risdate><volume>119</volume><issue>3</issue><spage>465</spage><epage>473</epage><pages>465-473</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><abstract>To study whether fertility preservation strategies using ovarian stimulation or without using it impact long-term disease-free survival of patients with breast cancer.
Retrospective bicentric cohort study.
Two university hospitals.
In this study, 740 women with breast cancer, aged 18–43 years, who received primary fertility preservation between 2013 and 2019 after a diagnosis of localized breast cancer were included.
Overall, 328 patients underwent at least 1 ovarian stimulation cycle (STIM group) and 412 had a technique without hormonal administration (no STIM group).
Disease-free survival and overall survival up to May 2021 were compared between the 2 groups by log-rank test. Cox proportional-hazard regression model was used for multivariable analyses.
Out of the 740 women who underwent fertility preservation, follow-up data were available for 269 women in the STIM group (82%) and 330 (80%) in the no STIM group. Kaplan-Meier estimates of disease-free survival at 4 years were 87.9% (82.8%–92.2%) and 83.1% (78.4%–87.3%) in the STIM and no STIM groups, respectively. After adjustment on prognostic parameters, no significant difference in breast cancer recurrence rate was observed between the STIM and no STIM groups (hazard ratios, 0.83 [0.64–1.08]). Kaplan-Meier estimate of overall survival at 4 years was 97.6% (95.3%–99.2%) and 93.6% (90.9%–95.9%) in the STIM and no STIM groups, respectively. Overall survival was higher in the STIM group than no STIM group (log-rank test). After adjustment on prognostic parameters, the risk of death remained significantly lower in the STIM group (Hazard Ratio, 0.55 [0.35–0.85]).
In our cohort, STIM for fertility preservation in breast cancer did not significantly impact disease-free survival but was associated with higher overall survival. The disease-free survival and overall survival of young patients with breast cancer were not impacted by fertility preservation techniques irrespective of the timing of chemotherapy (neoadjuvant or adjuvant) and the use of ovarian stimulation. Nevertheless, because death and recurrence were rare events, these results should be taken with caution.
El periodo libre de enfermedad no difiere según la técnica de preservación de la fertilidad en mujeres jóvenes con cáncer de mama.
Estudiar si las estrategias de preservación de la fertilidad con estimulación ovárica o sin ella influyen en la supervivencia sin enfermedad a largo plazo de las pacientes con cáncer de mama.
Estudio retrospectivo de cohortes bicéntrico.
Dos hospitales universitarios.
En este estudio, se incluyeron 740 mujeres con cáncer de mama, de entre 18 y 43 años, que realizaron inicialmente preservación de la fertilidad entre 2013 y 2019 tras un diagnóstico de cáncer de mama localizado.
En total, 328 pacientes se sometieron al menos a 1 ciclo de estimulación ovárica (grupo STIM) y 412 a una técnica sin administración hormonal (grupo no STIM).
El periodo libre de enfermedad y la supervivencia global hasta mayo de 2021, se compararon entre los 2 grupos mediante logranktest. Para los análisis multivariables se utilizó el modelo de regresión de riesgos proporcionales de Cox.
De las 740 mujeres que se sometieron a preservación de la fertilidad, se dispuso de datos de seguimiento de 269 mujeres del grupo STIM (82%) y 330 (80%) del grupo sin STIM. Las estimaciones de Kaplan-Meier de la supervivencia libre de enfermedad a los 4 años fueron del 87,9% (82,8%-92,2%) y del 83,1% (78,4%-87,3%) en los grupos STIM y no STIM, respectivamente. Tras ajustar los parámetros pronósticos, no se observaron diferencias significativas en la tasa de recurrencia del cáncer de mama entre los grupos con y sin STIM (cocientes de riesgo, 0,83 [0,64-1,08]). La estimación de Kaplan-Meier de la supervivencia global a los 4 años fue del 97,6% (95,3%-99,2%) y del 93,6% (90,9%-95,9%) en los grupos con y sin STIM, respectivamente. La supervivencia global fue mayor en el grupo con STIM que en el grupo sin STIM (log-rank test). Tras el ajuste de los parámetros pronósticos, el riesgo de muerte siguió siendo significativamente inferior en el grupo STIM (cociente de riesgo, 0,55 [0,35-0,85]).
En nuestra cohorte, la STIM para la preservación de la fertilidad en el cáncer de mama no tuvo un impacto significativo en la supervivencia libre de enfermedad, pero se asoció con una mayor supervivencia global. La supervivencia libre de enfermedad y la supervivencia global de las pacientes jóvenes con cáncer de mama no se vieron afectadas por las técnicas de preservación de la fertilidad, independientemente del momento de la quimioterapia (neoadyuvante o adyuvante) y del uso de la estimulación ovárica. No obstante, dado que la muerte y la recidiva fueron eventos poco frecuentes, estos resultados deben tomarse con cautela.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36473609</pmid><doi>10.1016/j.fertnstert.2022.11.020</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0875-1592</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0015-0282 |
| ispartof | Fertility and sterility, 2023-03, Vol.119 (3), p.465-473 |
| issn | 0015-0282 1556-5653 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2771085342 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present); Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Breast cancer Breast Neoplasms - drug therapy Cohort Studies controlled ovarian hyperstimulation Disease-Free Survival Female fertility preservation Fertility Preservation - methods Humans in vitro maturation Neoplasm Recurrence, Local Retrospective Studies |
| title | Disease-free survival does not differ according to fertility preservation technique for young women with breast cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T20%3A29%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Disease-free%20survival%20does%20not%20differ%20according%20to%20fertility%20preservation%20technique%20for%20young%20women%20with%20breast%20cancer&rft.jtitle=Fertility%20and%20sterility&rft.au=Sonigo,%20Charlotte&rft.date=2023-03&rft.volume=119&rft.issue=3&rft.spage=465&rft.epage=473&rft.pages=465-473&rft.issn=0015-0282&rft.eissn=1556-5653&rft_id=info:doi/10.1016/j.fertnstert.2022.11.020&rft_dat=%3Cproquest_cross%3E2771085342%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2771085342&rft_id=info:pmid/36473609&rft_els_id=S0015028222020489&rfr_iscdi=true |