Critical appraisal:Goldrat O, Kroman N, Peccatori FA, Cordoba O, Pistilli B, Lidegaard O, et al 2015

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Critical Appraisal

Article being appraised

Goldrat O, Kroman N, Peccatori FA, Cordoba O, Pistilli B, Lidegaard O, et al. Pregnancy following breast cancer using assisted reproduction and its effect on long-term outcome. Eur J Cancer 2015 Aug;51(12):1490-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26070684.


Applicable clinical question

Key Facts

Study Design

cohort study, risk factors

Study aims:

To evaluate the impact of ART on pregnancy and long-term outcomes of young breast cancer survivors.

Number of Patients:

198

198 patients were evaluated; of whom 25 underwent ART and the remainder had spontaneously conceived pregnancies.
Reported outcome(s):

Clinico-pathological characteristics, breast cancer treatment (date of diagnosis, histological type, histological grade, tumour size, nodal status, endocrine receptor status, human epidermal growth factor receptor 2 (HER2) status, type of breast surgery, chemo- and endocrine therapies), fertility treatments (ovulation induction, ovarian stimulation for IVF and oocyte donation) and pregnancy-related information (age at conception, number of pregnancies, and pregnancy outcome).

Results of outcome(s):

Patients had a long-term follow-up in the range of 9 and 8.5 years from breast cancer diagnosis and 5 and 4 years from conception, in the spontaneous and ART groups, respectively. No significant differences in breast cancer outcome were observed between both groups (p = 0.54, Table 3). Ten (5.7%) and two (8%) patients developed distant recurrences in the spontaneous and ART groups respectively. Contralateral breast cancer was reported in seven patients; all in the spontaneous pregnancy group. Eleven patients died in the spontaneous group (6.4%). Only one patient died in the ART group secondary to distant recurrence, which occurred 14 months after conception.

Comments on results:

Women who underwent ART had more favourable prognostic factors (groups not comparable), and only patients who achieved pregnancy were captured (unsuccessful ART procedures not included).

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
Moderate risk of bias Comments: Small numbers from five institutions. Groups not comparable.
Result of appraisal

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Completed by

Dr Jessica Harris

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Article
Goldrat O, Kroman N, Peccatori FA, Cordoba O, Pistilli B, Lidegaard O, et al. Pregnancy following breast cancer using assisted reproduction and its effect on long-term outcome. Eur J Cancer 2015 Aug;51(12):1490-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26070684.
Assigned to
User:Stefan.kane
Topic area
Guidelines:COSA:Cancer fertility preservation guidelines/Preconception assessment for cancer survivors
Clinical question
Form
Form:Critical appraisal


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