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Risk-adjusted benchmarking of long-term overall survival in patients with HER2-positive early-stage Breast cancer : A Swedish retrospective cohort study

Thurell, Jacob ; Manouchehri, Narges ; Fredriksson, Irma ; Wilking, Ulla ; Bergh, Jonas ; Ryden, Lisa LU orcid ; Koppert, Linetta B. ; Karsten, Maria M. ; Kiani, Narsis A. and Hedayati, Elham (2023) In Breast 70. p.18-24
Abstract

Aim: The main objective of the current study was to explore the value of risk-adjustment when comparing (i.e. benchmarking) long-term overall survival (OS) in breast cancer (BC) between Swedish regions. We performed risk-adjusted benchmarking of 5- and 10-year OS after HER2-positive early BC diagnosis between Sweden's two largest healthcare regions, constituting approximately a third of the total population in Sweden. Methods: All patients diagnosed with HER2-positive early-stage BC between 01-01–2009 and 31-12-2016 in healthcare regions Stockholm-Gotland and Skane were included in the study. Cox proportional hazards model was used for risk-adjustment. Unadjusted (i.e. crude) and adjusted 5- and 10-year OS was benchmarked between the... (More)

Aim: The main objective of the current study was to explore the value of risk-adjustment when comparing (i.e. benchmarking) long-term overall survival (OS) in breast cancer (BC) between Swedish regions. We performed risk-adjusted benchmarking of 5- and 10-year OS after HER2-positive early BC diagnosis between Sweden's two largest healthcare regions, constituting approximately a third of the total population in Sweden. Methods: All patients diagnosed with HER2-positive early-stage BC between 01-01–2009 and 31-12-2016 in healthcare regions Stockholm-Gotland and Skane were included in the study. Cox proportional hazards model was used for risk-adjustment. Unadjusted (i.e. crude) and adjusted 5- and 10-year OS was benchmarked between the two regions. Results: The crude 5-year OS was 90.3% in the Stockholm-Gotland region and 87.8% in the Skane region. The crude 10-year OS was 81.7% in the Stockholm-Gotland region and 77.3% in the Skane region. However, when adjusted for age, menopausal status and tumour biology, there was no significant OS disparity between the regions, neither at the 5-year nor 10-year follow-up. Conclusion: This study showed that risk-adjustment is relevant when benchmarking OS in BC, even when comparing regions from the same country that share the same national treatment guidelines. This is, to our knowledge, the first published risk-adjusted benchmarking of OS in HER2-positive BC.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast neoplasm, Databases, Factual/statistics and numerical data, Female, Quality improvement, Risk factor, Survival analysis, Survival rate
in
Breast
volume
70
pages
7 pages
publisher
Churchill Livingstone
external identifiers
  • pmid:37295176
  • scopus:85161261522
ISSN
0960-9776
DOI
10.1016/j.breast.2023.05.008
language
English
LU publication?
yes
id
76dab910-b504-4afa-8db6-e77a5e91a32b
date added to LUP
2023-08-15 12:37:46
date last changed
2024-04-20 00:37:40
@article{76dab910-b504-4afa-8db6-e77a5e91a32b,
  abstract     = {{<p>Aim: The main objective of the current study was to explore the value of risk-adjustment when comparing (i.e. benchmarking) long-term overall survival (OS) in breast cancer (BC) between Swedish regions. We performed risk-adjusted benchmarking of 5- and 10-year OS after HER2-positive early BC diagnosis between Sweden's two largest healthcare regions, constituting approximately a third of the total population in Sweden. Methods: All patients diagnosed with HER2-positive early-stage BC between 01-01–2009 and 31-12-2016 in healthcare regions Stockholm-Gotland and Skane were included in the study. Cox proportional hazards model was used for risk-adjustment. Unadjusted (i.e. crude) and adjusted 5- and 10-year OS was benchmarked between the two regions. Results: The crude 5-year OS was 90.3% in the Stockholm-Gotland region and 87.8% in the Skane region. The crude 10-year OS was 81.7% in the Stockholm-Gotland region and 77.3% in the Skane region. However, when adjusted for age, menopausal status and tumour biology, there was no significant OS disparity between the regions, neither at the 5-year nor 10-year follow-up. Conclusion: This study showed that risk-adjustment is relevant when benchmarking OS in BC, even when comparing regions from the same country that share the same national treatment guidelines. This is, to our knowledge, the first published risk-adjusted benchmarking of OS in HER2-positive BC.</p>}},
  author       = {{Thurell, Jacob and Manouchehri, Narges and Fredriksson, Irma and Wilking, Ulla and Bergh, Jonas and Ryden, Lisa and Koppert, Linetta B. and Karsten, Maria M. and Kiani, Narsis A. and Hedayati, Elham}},
  issn         = {{0960-9776}},
  keywords     = {{Breast neoplasm; Databases; Factual/statistics and numerical data; Female; Quality improvement; Risk factor; Survival analysis; Survival rate}},
  language     = {{eng}},
  pages        = {{18--24}},
  publisher    = {{Churchill Livingstone}},
  series       = {{Breast}},
  title        = {{Risk-adjusted benchmarking of long-term overall survival in patients with HER2-positive early-stage Breast cancer : A Swedish retrospective cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.breast.2023.05.008}},
  doi          = {{10.1016/j.breast.2023.05.008}},
  volume       = {{70}},
  year         = {{2023}},
}