Information on treatment outcome outside clinical trials is sparse. This is the first study that relates surgical and medical quality of care in daily practice with outcome. BACKGROUND: In a previous study we showed, that the quality of chemotherapy as described by a guideline and given in daily practice to premenopausal primary @entity0 @entity1 was suboptimal with only 68% and 53% of the @entity1 receiving chemotherapy with a @entity1213 ( @entity1213 ) and relative @entity1213 (RDI) of > or = 85%, respectively. Many invalid reasons for delay and dose reductions were identified. @entity1 AND METHODS: Premenopausal node-positive primary @entity0 @entity1 treated from 1988 to 1992 were traced using two national registries. Relevant data were collected from their records. The following treatment-related variables were correlated with prognosis: type of surgery, number of investigated lymph nodes, radiotherapy, chemotherapy, interval between surgery and start of chemotherapy, @entity1213 , duration, delays and dose adjustments of chemotherapy and hospital size. RESULTS: Twenty-four of the 254 traced @entity1 did not receive any chemotherapy, 230 received the recommended schedule of @entity786 (C), @entity1499 (M) and @entity1487 (F). The median time of follow-up was 6.7 (range 0.9-10.2) years. The 5-year disease-free survival (DFS) and @entity1349 ( @entity1349 ) was 61% and 77%, respectively. In an univariate analysis @entity1213 < 65% correlated with a worse DFS and @entity1349 (p=0.05 and p=0.03, respectively). The use of chemotherapy correlated with a better DFS (p=0.03) than no use. In a multivariate analysis @entity1213 between 65 and 85% resulted in a better DFS (p=0.02) than @entity1213 > or = 85% and @entity1213 < 65%. CONCLUSION: The prognosis of the @entity0 @entity1 in this population was comparable with the results of randomised trials using adjuvant CMF. The only treatment related variable of value for prognosis was @entity1213 . Unexpectedly @entity1213 between 65% and 85% resulted in the best prognosis in this population. The relevance of this observation remains unclear and warrants further investigation.

Effects of quality of treatment on prognosis in primary @entity0 XXXX treated in daily practice.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity1213 :: ('MESH:D012555', 'Disease') :: ['DI', 'dose intensity'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['methotrexate'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity1 :: (9606,Species) :: ['patients']
