Critical appraisal:Kim J, Turan V, Oktay K 2016

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Critical Appraisal

Article being appraised

Kim J, Turan V, Oktay K. Long-Term Safety of Letrozole and Gonadotropin Stimulation for Fertility Preservation in Women With Breast Cancer. J Clin Endocrinol Metab 2016 Apr;101(4):1364-71 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26751194.


Applicable clinical question

Key Facts

Study Design

cohort study, risk factors

Study aims:

prospective, nonrandomized, controlled study
We aimed to investigate the long-term safety of FP via controlled ovarian stimulation with letrozole supplementation (COSTLES) prior to breast cancer treatment.

Number of Patients:

337

A total of 337 women diagnosed with stage 3 or less invasive breast cancer were enrolled during a FP consultation before chemotherapy. Of those, 120 elected to undergo COSTLES for FP prior to chemotherapy (FP group). The remaining 217 patients did not undergo any FP procedure and served as the controls.
Reported outcome(s):

The primary end point was cancer recurrence defined as the detection of locoregional tumor (chest wall, regional nodal disease), distant metastases, or contralateral invasive breast cancer.

Results of outcome(s):

In the FP group, the hazard ratio for recurrence after ovarian stimulation was 0.77 (95% confidence interval 0.28–2.13), and the survival was not compromised compared with controls (P = .61). Neither BRCA gene mutation status (P = .57) nor undergoing FP before or after breast surgery (P = .44) affected survival outcomes in the FP group. Likewise, none of the tumor characteristics including the estrogen receptor status affected the survival rates after the COSTLES.


Evidence ratings

Level of evidence

II

Risk of bias
High risk of bias Comments:
Result of appraisal

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Article
Kim J, Turan V, Oktay K. Long-Term Safety of Letrozole and Gonadotropin Stimulation for Fertility Preservation in Women With Breast Cancer. J Clin Endocrinol Metab 2016 Apr;101(4):1364-71 Available from: http://www.ncbi.nlm.nih.gov/pubmed/26751194.
Assigned to
User:Rebecca.deans
Topic area
Guidelines:COSA:Cancer fertility preservation guidelines/Options for treatment
Clinical question
Form
Form:Critical appraisal


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