UniCancer Group

The aim of this study was to assess return to work (RTW) after breast cancer (BC) by baseline employment status. Using data from the CANTO cohort (NCT01993498), we examined RTW among women below age 57 at BC diagnosis 2 and 4 years after BC diagnosis. We also assessed continuous work between years 2 and 4 post-diagnosis. Poisson regression models investigated associations between baseline employment (self-employed vs. employees) and RTW outcomes, adjusting for clinical, sociodemographic, and work-related factors and quality of life. We used education (above high school; high school or lower) as a proxy to further distinguish between white collar self-employees vs. blue collar self-employees (vs. employees). About 8% of women were self-employed at diagnosis. RTW was slightly higher among the self-employed compared to employees 2 years (N = 3178; PR = 1.04, 95%CI 0.98–1.10) and 4 years after diagnosis (N = 2329; PR = 1.05, 0.99–1.12). This effect was limited to white collar self-employed women. Among those who returned to work 2 years after diagnosis (N = 1683), self-employed women showed a 1.15 (1.01–1.31) higher prevalence of continuous work until year 4 post-diagnosis than employees. Self-employed women do not strongly differ from employees when assessing RTW at specific time points, however once returned to work, they experience fewer work interruptions than employees. This was observed in adjusted models, showing the intrinsic importance of job status in the RTW process. These findings highlight the importance of viewing RTW as an ongoing process, in order to provide appropriate and sustained support.

BackgroundPatients treated for rare ovarian germ cell tumors (GCT) and sex cord stromal tumors (SCST) often experience long-term survival. Treatments include surgery with or without chemotherapy (CT), which can cause late side effects that negatively impact quality of life (QoL). This study assessed long-term QoL among GCT and SCST survivors compared to age-matched healthy women (HW), focusing on patients treated with CT.MethodsCancer-free GCT and SCST survivors (≥ 2 years post-treatment) were recruited from the INCa French Network TMRG. HW were recruited via the “Seintinelles” platform. Participants completed validated questionnaires assessing QoL (FACT-G/FACT-O), fatigue (MFI), anxiety/depression (HADS), insomnia (ISI), neurotoxicity (FACT/GOG-NTX), cognition (FACT-COG), and sexuality (FACT-O OCS). Clinically relevant differences were defined as ≥ 5% between groups.ResultsA total of 144 survivors (99 GCT and 45 SCST) were included and compared with 284 matched HW (median age: 35.2 years). The median time from the end of treatment was 6 years [Q1 3.5–Q3 9.3]. At inclusion, 42% of patients were menopausal compared to 17% of HW (p < 0.001), with reduced sexual QoL. Survivors reported more cognitive impairment (32% vs. 21%, p = 0.025) and severe neurotoxicity (23% vs. 8%, p < 0.001). QoL, fatigue, anxiety/depression, and insomnia scores were similar for patients and HW.ConclusionsWith a median of 6 years after CT, most GCT and SCST survivors reported similar overall QoL compared to HW but faced premature menopause, reduced sexual QoL, and persistent cognitive and neurotoxic effects.Trial registration numberNCT03418844.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04540-x.

To evaluate the surgical management and oncologic outcomes of patients with FIGO stage IV ovarian cancer, using data from the French national ESME cohort. This retrospective multicenter study included patients diagnosed with FIGO stage IV ovarian cancer between January 2011 and December 2016, treated in 18 French Comprehensive Cancer Centers participating in the ESME-OVR program. Clinical characteristics, treatment strategies, metastatic site patterns, and survival outcomes (overall survival [OS], progression-free survival [PFS]) were analyzed and compared between FIGO IVA and IVB stages. A total of 159 patients were identified, of whom 107 (67.3 ​%) had FIGO stage IVB disease. Regardless of metastatic stage, surgical strategies and were comparable. Complete debulking surgery was achieved in 75 ​% of cases. Most of FIGO stage IVB patients (88.8 ​%) presented a single metastatic site including extra-abdominal lymph nodes (50.5 ​%), liver (20.6 ​%), and lungs (10.3 ​%); 15.9 ​% of patient with distant metastases underwent local treatment and predominantly targeted nodal disease. Complete debulking surgery was significantly associated with improved OS and PFS (p ​= ​0.002 and p ​< ​0.001, respectively), while local treatment of metastases did not provide survival benefit. The number of metastatic sites did not significantly influence prognosis. Complete debulking surgery is the critical factor from a progronostic point of view, whether in FIGO stage IVA or IVB. Feasibility of local treatment for distant metastases is observed, its impact on oncologic outcomes remains unclear and we need further prospective investigation. Surgical strategies should be integrated into a personalized approach to optimize management in advanced-stage disease.

<h3>Background</h3> The purpose of this study was to describe patient profiles and real-world outcomes and identify prognostic factors among patients with common epidermal growth factor receptor (<i>EGFR</i>)–mutated advanced non-small-cell lung cancer (NSCLC) treated with first-line (1L) or second-line (2L) osimertinib. <h3>Patients and methods</h3> This retrospective study used data from the Epidemiological Strategy and Medical Economics (ESME; France), Rigshospitalet/Herlev Hospital (RH; Denmark), and National Cancer Registration and Analysis Service (NCRAS; UK) databases. Progression-free survival (PFS), time to treatment discontinuation (TTD), time to next therapy (TTNT), and overall survival (OS) were analyzed using Kaplan–Meier estimates. Prognostic factors for outcomes were identified using univariate and multivariable proportional hazards regression. <h3>Results</h3> A total of 1646 patients were included (ESME, <i>n</i> = 624; RH, <i>n</i> = 133; NCRAS, <i>n</i> = 889). For patients receiving 1L osimertinib, median PFS, TTD, TTNT, and OS were 11.9, 15.0, 18.8, and 24.8 months, respectively. Corresponding values for 2L osimertinib were 7.4, 10.0, 11.9, and 17.1 months. Although distinct prognostic factors were identified for different outcomes and lines of treatment, poor Eastern Cooperative Oncology Group performance status score, presence of exon 21 L858R substitutions, and liver metastases were consistently associated with poorer outcomes across all endpoints. Of 771 patients receiving 1L osimertinib, at least 38% died before initiating a 2L treatment; 41% of patients receiving 2L osimertinib (<i>n</i> = 875) died before initiating a third-line treatment. The most common subsequent therapy was chemotherapy [1L osimertinib, 47% (97/208); 2L osimertinib, 52% (193/368)]. <h3>Conclusion</h3> This retrospective real-world analysis highlights the unmet need for more effective treatment options in common <i>EGFR</i>-mutated advanced NSCLC.