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Titolo:
OVARIAN ABLATION IN EARLY BREAST-CANCER - OVERVIEW OF THE RANDOMIZED TRIALS
Autore:
CLARKE M; COLLINS R; DAVIES C; GODWIN J; GRAY R; PETO R; ABE O; ABE R; ENOMOTO K; KIKUCHI K; KOYAMA H; NOMURA Y; SAKAI K; SUGIMACHI K; TOMINAGA T; UCHINO J; YOSHIDA M; VANDEVELDE AO; VANDONGEN JA; VERMORKEN JB; ARVELAKIS A; GIOKAS G; LISSAIOS B; HARVEY VJ; HOLDAWAY TM; KAY RG; MASON BH; COATES A; FORBES JF; FOCAN C; LOBELLE JP; PEEK U; OATES GD; POWELL J; BASTERT G; RAUSCHECKER H; SAUER R; SAUERBREI W; SCHAUER A; SCHUMACHER M; DURAND M; MAURIAC L; BARTHOLOMEUS S; PICCART MJ; GELMAN RS; HENDERSON IC; SHAPIRO CL; HANCOCK AK; MASOOD MB; PARKER D; PRICE JJ; JACKSON S; RAGAZ J; DELOZIER T; MACELESECH J; HAYBITTLE JL; CIRRINCIONE C; KORZUN A; WEISS RB; WOOD WC; BAUM M; HOUGHTON J; RILEY D; DENT DM; GUDGEON CA; HACKING A; HORGAN K; HUGHES L; STEWART HJ; GORDON NH; DAVIS HL; LEHINGUE Y; OWEN JR; MEIER P; HOWELL A; RIBEIRO GC; SWINDELL R; ALBANO J; DEOLIVEIRA CF; GERVASIO H; GORDILHO J; CARSTENSEN B; PALSHOF T; JOHANSEN H; KORZENIOWSKI S; SKOLYSZEWSKI J; ANDERSEN KW; AXELSSON CK; BLICHERTTOFT M; MOURIDSEN HT; OVERGAARD M; ROSE C; CORCORAN N; TRAMPISCH HJ; ABELOFF MD; CARBONE PC; GLICK J; TORMEY DC; ROSSBACH J; SCANLON EF; SCHURMAN S; DESCHRYVER A; YOSEF HMA; MCARDLE CS; SMITH DC; LARA PC; BOCCARDO F; ERAZO A; MEDINA JY; IZUO M; MORISHITA Y; BENTLEY A; DORAN Z; FENTIMAN IS; HAYWARD JL; RUBENS RD; KAUFMANN M; JONAT W; SCHEURLEN H; VONFOURNIER D; FOUNTZILAS G; KLEFSTROM P; BLOMQVIST C; CUZICK J; MARGREITER R; CASTIGLIONE M; CAVALLI F; COLLINS J; FORBES J; GELBER RD; GOLDHIRSCH A; LINDTNER J; PRICE KN; RUDENSTAM CM; SENN HJ; BLISS JM; CHILVERS CED; COOMBES RC; MARTY M; BOROVIK R; BRUFMAN G; HAYAT H; ROBINSON E; WIGLER N; PANNUTI F; TAKASHIMA S; TASUTOMI T; SONOO H; YAMASHITA J; OGAWA M; HUPPERETS PSGJ; BONTE J; TENGRUP I; TENNVALLNITTBY L; MARTIN P; ROMAIN S; AHMANN D; SCHAID DJ; BUZDAR AU; SMITH T; HAKES T; NORTON L; WITTES R; DELAHUERTA R; SAINZ MG; BONADONNA G; DELVECCHIO M; VALAGUSSA P; VERONESI U; DUBOIS JB; BIANCO AR; LIPPMAN ME; PIERCE LJ; SIMON R; STEINBERG SM; BROWN A; FISHER B; REDMOND C; WOLMARK N; JACKSON IM; PALMER MK; INGLE JN; SUMAN VJ; BENGTSSON NO; LARSSON LG; LYTHGOE JP; KISSIN M; HANNISDAL E; VARHAUG JE; NISSENMEYER R; BLAMEY RW; MITCHELL AK; ROBERTSON JFR; NAKAMURA Y; MATHE G; MISSET JL; ABUZAHRA HT; CLARKE EA; MCLAUGHLIN JR; CLARK RM; LEVINE M; MYLES JD; PATER JL; PRITCHARD KI; MORIMOTO K; SAWA K; TAKATSUKA Y; GUNDERSEN S; HAUERJENSEN M; HOST A; CROSSLEY E; DURRANT K; HARRIS A; BEIGHTON A; COLLINS R; EVANS V; GREAVES E; HARWOOD C; JAMES S; LAU E; MEAD G; MULDAL A; NAUGHTON A; TOOTH A; WHEATLEY K; RAMBERT P; ASSELAIN B; SALMON RJ; VILCOQ JR; ARRIAGADA R; HILL C; LAPLANCHE A; LE MG; SPEILMANN M; COCCONI G; DIBLASIO B; CATALANO R; CREECH RH; BROCKSCHMIDT J; COOPER MR; ANDRYSEK O; BARKMANOVA J; FALKSON CJ; ABRAHAM M; KLIJN JGM; TREURNIETDONKER AD; VANPUTTEN WLJ; EASTON D; POWLES TJ; GAZET JC; SEMIGLAZOV V; DESHPANDE N; DIMARTINO L; DOUGLAS P; HOST H; BRYANT AJS; EWING GH; KRUSHENKOSLOSKI JL; FORREST APM; JACK W; MCDONALD C; MOLLER TR; RYDEN S; CARSTENSEN J; HATSCHEK T; SODERBERG M; CARPENTER JT; ALBAIN K; CROWLEY J; GREEN S; MARTINO S; OSBORNE CK; RAVDIN PM; RUTQVIST LE; WALLGREN A; HOLM LE; YOSHIMOTO M; DEBOER G; PATERSON AHG; MEAKIN JW; PANZARELLA T; NAJA A; BAHI J; REID M; SPITTLE M; SENANAYAKE F; BERGH J; HOLMBERG L; SEVELDA P; ZIELINSKY CC; JAKESZ R; GNANT M; BUCHANAN RB; CROSS M; DUNN JA; GILLESPIE WM; KELLY K; MORRISON JM; LITTON A; CHLEBOWSKI RT; BEZWODA WR; CAFFIER H;
Indirizzi:
RADCLIFFE INFIRM,CLIN TRIAL SERV UNIT OXFORD OX2 6HE ENGLAND AMSTERDAM INTEGRAAL KANKERCTR AMSTERDAM NETHERLANDS ATHENS METAXAS MEM CANC HOSP ATHENS GREECE AUCKLAND BREAST CANC STUDY GRP AUCKLAND NEW ZEALAND CARDIFF SURG TRIALISTS CARDIFF S GLAM WALES BERLIN BUCH AKAD WISSENSCH BERLIN GERMANY BIRMINGHAM GEN HOSP BIRMINGHAM W MIDLANDS ENGLAND BMFT FREIBERG FREIBERG GERMANY BORDEAUX INST BERGONIE BORDEAUX FRANCE DANA FARBER CANC INST BOSTON MA 02115 BRADFORD ROYAL INFIRM BRADFORD BD9 6RJ W YORKSHIRE ENGLAND BRITISH COLUMBIA CANC AGCY VANCOUVER BC V5Z 4E6 CANADA CAEN CTR REG FRANCOIS BACLESSE CAEN FRANCE ADDENBROOKES HOSP CAMBRIDGE ENGLAND CANC & LEUKEMIA GRP B DURHAM NC 00000 CANC RES CAMPAIGN LONDON SW1Y 5AR ENGLAND GROOTE SCHUUR HOSP ZA-7925 CAPE TOWN SOUTH AFRICA CASE WESTERN RESERVE UNIV CLEVELAND OH 44106 CTR LEON BERARD F-69373 LYON FRANCE CHELTENHAM GEN HOSP CHELTENHAM GLOS ENGLAND UNIV CHICAGO CHICAGO IL 60637 CHRISTIE HOSP & HOLT RADIUM INST MANCHESTER M20 9BX LANCS ENGLAND COIMBRA INST ONCOL COIMBRA PORTUGAL DANISH CANC REGISTRY COPENHAGEN DENMARK COPENHAGEN RADIUM CTR COPENHAGEN DENMARK CRACOW INST ONCOL KRAKOW POLAND ST LUKES HOSP DUBLIN IRELAND UNIV DUSSELDORF D-4000 DUSSELDORF GERMANY EASTERN COOPERAT ONCOL GRP BOSTON MA 00000 EUROPEAN ORG RES TREATMENT CANC BRUSSELS BELGIUM NORTHWESTERN UNIV,EVANSTON HOSP EVANSTON IL 60201 STATE UNIV GHENT HOSP B-9000 GHENT BELGIUM WESTERN INFIRM & ASSOCIATED HOSP,BEATSON ONCOL CTR GLASGOW G11 6NT LANARK SCOTLAND GLASGOW VICTORIA INFIRM GLASGOW LANARK SCOTLAND GRANADA UNIV HOSP GRANADA SPAIN GUADALAJARA HOSP 20 NOVIEMBRE GUADALAJARA JALISCO MEXICO GUNMA UNIV MAEBASHI GUMMA 371 JAPAN GUYS HOSP LONDON SE1 9RT ENGLAND HEIDELBERG UNIV 1 HEIDELBERG GERMANY HEIDELBERG UNIV 2 HEIDELBERG GERMANY HELLENIC COOPERAT ONCOL GRP ATHENS GREECE HELSINKI DEACONESS MED CTR HELSINKI FINLAND UNIV HELSINKI FIN-00014 HELSINKI FINLAND IMPERIAL CANC RES FUND LONDON WC2A 3PX ENGLAND INNSBRUCK UNIV A-6020 INNSBRUCK AUSTRIA LUDWIG INT BREAST CANC STUDY GRP EPALINGES SWITZERLAND INT COLLABORAT CANC GRP LONDON ENGLAND ISRAEL NSABC JERUSALEM ISRAEL KAWASAKI MED UNIV KAWASAKI KANAGAWA JAPAN KUMAMOTO UNIV GRP KUMAMOTO JAPAN KYUSHU NATL CANC CTR FUKUOKA JAPAN BREAST CANC STUDY GRP COMPREHENS CANC CTR LIMBURG NETHERLANDS ACAD ZIEKENHUIS ST RAFAEL LOUVAIN BELGIUM MARSEILLE LAB CANCEROL BIOL APM MARSEILLE FRANCE MAYO CLIN ROCHESTER MN 55905 UNIV TEXAS,MD ANDERSON CANC CTR HOUSTON TX 00000 MEXICAN NATL MED CTR MEXICO CITY DF MEXICO IST NAZL STUDIO & CURA TUMORI I-20133 MILAN ITALY CTR PAUL LAMARQUE MONTPELLIER FRANCE UNIV NAPLES I-80138 NAPLES ITALY NCI BETHESDA MD 20892 NORTHWICK PK HOSP & CLIN RES CTR HARROW HA1 3UJ MIDDX ENGLAND NORWEGIAN RADIUM HOSP OSLO NORWAY CITY HOSP NOTTINGHAM NOTTINGHAM ENGLAND OITA PREFECTURAL HOSP OITA JAPAN ONTARIO CANC TREATMENT & RES FDN TORONTO ON CANADA ONTARIO CLIN ONCOL GRP HAMILTON ON CANADA CANADA CLIN TRIALS GRP,ONTARIO NATL CANC INST KINGSTON ON CANADA OSAKA CITY UNIV OSAKA 558 JAPAN OSAKA NATL HOSP OSAKA JAPAN OSLO RADIUM HOSP OSLO NORWAY OXFORD CHURCHILL HOSP OXFORD ENGLAND OXFORD ICRF MRC CLIN TRIAL SERV UNIT OXFORD ENGLAND CTR RENE HUGUENIN PARIS FRANCE INST CURIE PARIS FRANCE INST GUSTAVE ROUSSY PARIS FRANCE PARMA HOSP PARMA ITALY FOX CHASE CANC CTR PHILADELPHIA PA 19111 PIEDMONT ONCOL ASSOC WINSTON SALEM NC 00000 CHARLES UNIV PRAGUE CZECH REPUBLIC UNIV PRETORIA ZA-0002 PRETORIA SOUTH AFRICA INST CARDIOVASC ROSARIO ROSARIO ARGENTINA DR DANIEL DEN HOED CANC CTR NL-3008 AE ROTTERDAM NETHERLANDS ROYAL MARSDEN HOSP,CANC RES INST LONDON ENGLAND UNIV LONDON ST GEORGES HOSP LONDON SW17 0RE ENGLAND ST PETERSBURG PETROV RES INST ONCOL ST PETERSBURG RUSSIA SARDINIA ONCOL HOSP A BUSINICO SARDINIA ITALY SASKATCHEWAN CANC FDN SASKATOON SK CANADA SCOTTISH CANC TRIALS OFF EDINBURGH MIDLOTHIAN SCOTLAND SW ONCOL GRP KANSAS CITY KS 00000 STOCKHOLM BREAST CANC STUDY GRP STOCKHOLM SWEDEN KAROLINSKA HOSP S-10401 STOCKHOLM SWEDEN SAKK & OSAKO,SWISS GRP CLIN CANC RES BERN SWITZERLAND TEL AVIV UNIV IL-69978 TEL AVIV ISRAEL CANC INST HOSP TOKYO JAPAN TORONTO EDMONTON BREAST CANC STUDY GRP TORONTO ON CANADA PRINCESS MARGARET HOSP TORONTO ON M4X 1K9 CANADA CTR CLAUDIUS REGAUD TOULOUSE FRANCE INST SALAH AZAIZ TUNIS TUNISIA UPPSALA OREBRO CANC STUDY GRP UPPSALA SWEDEN
Titolo Testata:
Lancet
fascicolo: 9036, volume: 348, anno: 1996,
pagine: 1189 - 1196
SICI:
0140-6736(1996)348:9036<1189:OAIEB->2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
M. Clarke et al., "OVARIAN ABLATION IN EARLY BREAST-CANCER - OVERVIEW OF THE RANDOMIZED TRIALS", Lancet, 348(9036), 1996, pp. 1189-1196

Abstract

Background Among women with early breast cancer, the effects of ovarian ablation on recurrence and death have been assessed by several randomised trials that now have long follow-up. In this report, the Early Breast Cancer Trialists' Collaborative Group present their third 5-yearly systematic overview (meta-analysis), now with 15 years' follow-up. Methods in 1995, information was sought on each patient in any randomised trial of ovarian ablation or suppression versus control that began before 1990. Data were obtained for 12 of the 13 studies that assessed ovarian ablation by irradiation or surgery, all of which began before 1980, but not for the four studies that assessed ovarian suppression by drugs, all of which began after 1985. Menopausal status was not consistently defined across trials; therefore, the main analyses are limited to women aged under 50 (rather than ''premenopausal'') when randomised. Oestrogen receptors were measured only in the trials of ablation plus cytotoxic chemotherapy versus the same chemotherapy alone. Findings Among 2102 women aged under 50 when randomised, most of whom would have been premenopausal at diagnosis, 1130 deaths and an additional153 recurrences were reported. 15-year survival was highly significantly improved among those allocated ovarian ablation (52 . 4 vs 46 . 1%, 6 . 3 [SD 2 . 3] fewer deaths per 100 women, logrank 2p=0 . 001), aswas recurrence-free survival (45 . 0 vs 39 . 0%, 2p=0 . 0007). The numbers of events were too small for any subgroup analyses to be reliable. The benefit was, however, significant both for those with (''node positive'') and for those without (''node negative'') axillary spread when diagnosed. In the trials of ablation plus cytotoxic chemotherapy versus the same chemotherapy alone, the benefit appeared smaller (even for women with oestrogen receptors detected on the primary tumour) than in the trials of ablation in the absence of chemotherapy (where the observed survival improvements were about six per 100 node-negative women and 12 per 100 node-positive women). Among 1354 women aged 50 or over when randomised, most of whom would have been perimenopausal or postmenopausal, there was only a non-significant improvement in survivaland recurrence-free survival. Interpretation In women aged under 50 with early breast cancer, ablation of functioning ovaries significantlyimproves long-term survival, at least in the absence of chemotherapy. Further randomised evidence is needed on the additional effects of ovarian ablation in the presence of other adjuvant treatments, and to assess the relevance of hormone-receptor measurements.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 21:19:06