ArticlesOvarian ablation in early breast cancer: overview of the randomised trials
Introduction
Since 1985 the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) has, every 5 years, organised systematic overviews (meta-analyses) of data from individual patients from all randomised trials of the treatment of operable breast cancer.1, 2, 3, 4 This report presents the information from the third cycle for trials of ovarian ablation, based on the data collected in 1995, which yields at least 15 years of follow-up for most women.
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Methods
Trial identification and data-checking procedures for the EBCTCG overviews have been described.1, 2, 3 The aim here was to review all properly randomised trials that began recruiting before 1990 and compared the ablation or suppression of ovarian function, sometimes with the addition of prednisone, versus no such adjuvant treatment. In practice, all the trials that can be reviewed here began before 1980, and all involved surgical or radiotherapeutic ablation (see below). To be “properly
Women aged under 50 at entry
Recurrence-free survival-Among women aged under 50, by year 15 there were 6·0 (SD 2·3) fewer recurrences or deaths per 100 women allocated ovarian ablation (45·0vs39·0% alive and with no history of local or distant recurrence 15 years after randomisation, logrank 2p=0·0007, Figure 1, recurrence-free survival). This highly significant difference was, in absolute terms, somewhat smaller than had been suggested by the previous cycle of higher in the first 5 years than later, most of the absolute
Discussion
For women aged under 50 years, most of whom were premenopausal when diagnosed, these updated analyses continue to show that ovarian ablation produced a highly significant improvement in recurrence-free and in overall survival. The relevance of nodal status could be assessed only in trials of ovarian ablation in the absence of cytotoxic chemotherapy, and in these there was significant benefit both for women with and for those without axillary spread. The risk reduction produced by ovarian
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List of participants at end of report