| Institution: | 1.Medical Oncology Department,Hospital Universitario Central de Asturias,Oviedo,Spain;2.Hematology and Medical Oncology Department,Hospital Universitario Morales Meseguer, UMU, IMIB,Murcia,Spain;3.Medical Oncology Department,Hospital General Universitario de Elche,Alicante,Spain;4.Medical Oncology Department,Hospital Universitario La Paz,Madrid,Spain;5.Medical Oncology Department,Hospital Universitario de Canarias,Santa Cruz De Tenerife,Spain;6.Medical Oncology Department,Pontificia Universidad Católica de Chile,Santiago De Chile,Chile;7.Medical Oncology Department,Hospital Universitario Gregorio Mara?ón,Madrid,Spain;8.Medical Oncology Department,Hospital General de Ciudad Real,Ciudad Real,Spain;9.Pharmacy Department,Hospital Universitario Central de Asturias,Oviedo,Spain;10.Medical Oncology Department,Hospital Galdakao-Usansolo,Usansolo,Spain;11.Medical Oncology Department,Hospital Universitario Parc Tauli,Sabadell,Spain;12.Medical Oncology Department,Hospital Universitario Insular de Gran Canaria,Las Palmas De Gran Canaria,Spain;13.Medical Oncology Department,Hospital Universitario del Mar,Barcelona,Spain;14.Medical Oncology Department,Complejo Hospitalario de Navarra,Pamplona,Spain;15.Medical Oncology Department,Hospital Clínic,Barcelona,Spain;16.Medical Oncology Department,Hospital Universitario Doce de Octubre,Madrid,Spain;17.Medical Oncology Department,Hospital Universitario Marqués de Valdecilla,Santander,Spain;18.Medical Oncology Department,Hospital Universitario Son Espases,Mallorca,Spain;19.Medical Oncology Department,Hospital Universitario Ramón y Cajal,Madrid,Spain;20.Medical Oncology Department,Clínica Universidad de Navarra,Pamplona,Spain;21.Medical Oncology Department,Hospital Santa Lucía,Cartagena,Spain;22.Medical Oncology Department,Hospital Universitario Virgen del Rocío,Seville,Spain;23.Medical Oncology Department,Instituto Oncológico Teknon,Barcelona,Spain;24.Medical Oncology Department,Complejo Hospitalario de Orense,Ourense,Spain;25.Medical Oncology Department,Hospital Universitario Reina Sofía de Córdoba,Córdoba,Spain;26.Medical Oncology Department,Hospital Universitario Miguel Servet de Zaragoza,Zaragoza,Spain;27.Medical Oncology Department,Hospital Universitario Vall d’Hebron and VHIO—Vall d’Hebron Institute of Oncology,Barcelona,Spain;28.Medical Oncology Department,Hospital Universitario Fundación Alcorcon,Madrid,Spain |
| Abstract: | BackgroundTrastuzumab significantly improves overall survival (OS) when added to cisplatin and fluoropyrimidine as a treatment for HER2-positive advanced gastric cancers (AGC). The aim of this study was to evaluate the impact of the gradual implementation of HER2 testing on patient prognosis in a national registry of AGC.MethodsThis Spanish National Cancer Registry includes cases who were consecutively recruited at 28 centers from January 2008 to January 2016. The effect of missing HER2 status was assessed using stratified Cox proportional hazards (PH) regression.ResultsThe rate of HER2 testing increased steadily over time, from 58.3 % in 2008 to 92.9 % in 2016. HER2 was positive in 194 tumors (21.3 %). In the stratified Cox PH regression, each 1 % increase in patients who were not tested for HER2 at the institutions was associated with an approximately 0.3 % increase in the risk of death: hazard ratio, 1.0035 (CI 95 %, 1.001–1.005), P = 0.0019. Median OS was significantly lower at institutions with the highest proportions of patients who were not tested for HER2.ConclusionPatients treated at centers that took longer to implement HER2 testing exhibited worse clinical outcomes. The speed of implementation behaves as a quality-of-care indicator. Reviewed guidelines on HER2 testing should be used to achieve this goal in a timely manner. |
