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

Jacob Thurell; Narges Manouchehri; Irma Fredriksson; Ulla Wilking; Jonas Bergh; Lisa Ryden; Linetta B. Koppert; Maria M. Karsten; Narsis A. Kiani; Elham Hedayati

doi:10.1016/j.breast.2023.05.008

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

Jacob Thurell^*, Narges Manouchehri, Irma Fredriksson, Ulla Wilking, Jonas Bergh, Lisa Ryden, Linetta B. Koppert, Maria M. Karsten, Narsis A. Kiani, Elham Hedayati

^*Corresponding author for this work

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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 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.

Original language	English
Pages (from-to)	18-24
Number of pages	7
Journal	Breast
Volume	70
DOIs	https://doi.org/10.1016/j.breast.2023.05.008
Publication status	Published - Aug 2023

Bibliographical note

Funding
This work was supported by a grant from the Swedish Breast Cancer Association (BCF). We also acknowledge the support of the Natural Sciences and Engineering Research Council of Canada (NSERC), [funding reference number PDF568028-2022]. Cette recherche a été financée par le Conseil de recherches en sciences naturelles et en génie du Canada (CRSNG), [numéro de référence PDF568028-2022].

Publisher Copyright: © 2023

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1-s2.0-S0960977623005040-mainFinal published version, 1.64 MBLicence: CC BY

Cite this

@article{92b1d3f91e06412f9472d9924581c337,

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

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 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.",

author = "Jacob Thurell and Narges Manouchehri and Irma Fredriksson and Ulla Wilking and Jonas Bergh and Lisa Ryden and Koppert, {Linetta B.} and Karsten, {Maria M.} and Kiani, {Narsis A.} and Elham Hedayati",

note = "Funding This work was supported by a grant from the Swedish Breast Cancer Association (BCF). We also acknowledge the support of the Natural Sciences and Engineering Research Council of Canada (NSERC), [funding reference number PDF568028-2022]. Cette recherche a {\'e}t{\'e} financ{\'e}e par le Conseil de recherches en sciences naturelles et en g{\'e}nie du Canada (CRSNG), [num{\'e}ro de r{\'e}f{\'e}rence PDF568028-2022]. Publisher Copyright: {\textcopyright} 2023",

year = "2023",

month = aug,

doi = "10.1016/j.breast.2023.05.008",

language = "English",

volume = "70",

pages = "18--24",

journal = "Breast",

issn = "0960-9776",

publisher = "Churchill Livingstone",

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TY - JOUR

T1 - Risk-adjusted benchmarking of long-term overall survival in patients with HER2-positive early-stage Breast cancer

T2 - A Swedish retrospective cohort study

AU - Thurell, Jacob

AU - Manouchehri, Narges

AU - Fredriksson, Irma

AU - Wilking, Ulla

AU - Bergh, Jonas

AU - Ryden, Lisa

AU - Koppert, Linetta B.

AU - Karsten, Maria M.

AU - Kiani, Narsis A.

AU - Hedayati, Elham

N1 - Funding This work was supported by a grant from the Swedish Breast Cancer Association (BCF). We also acknowledge the support of the Natural Sciences and Engineering Research Council of Canada (NSERC), [funding reference number PDF568028-2022]. Cette recherche a été financée par le Conseil de recherches en sciences naturelles et en génie du Canada (CRSNG), [numéro de référence PDF568028-2022]. Publisher Copyright: © 2023

PY - 2023/8

Y1 - 2023/8

N2 - 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.

AB - 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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DO - 10.1016/j.breast.2023.05.008

M3 - Article

C2 - 37295176

AN - SCOPUS:85161261522

SN - 0960-9776

VL - 70

SP - 18

EP - 24

JO - Breast

JF - Breast

ER -

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

Abstract

Bibliographical note

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