Li Jun-Jie, Yu Ke-DA, DI Gen-Hong, Shao Zhi-Min
Department of Breast Surgery, Cancer Hospital/Cancer Institute, and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China.
Oncol Lett. 2010 Nov;1(6):1037-1043. doi: 10.3892/ol.2010.179. Epub 2010 Sep 23.
This study aimed to determine the clinicopathological features and treatment sensitivity of elderly breast cancer patients in China. The clinical data of 594 elderly breast cancer patients of 70 or more years of age were collected and compared to those of 657 patients of less than 70 years of age to analyze whether breast cancer in the elderly is different and whether the difference affected outcome. The median age was 75.2 years in the elderly patients and 49.8 years in the young patients. Age of menarche, parous status and body mass index were similar in the two groups. A higher frequency of steroid receptor-positive rate, a lower expression of HER-2 and p53, less axillary node-positive rate and earlier tumor stage were found in patients of 70 years or older. The 5-year relapse-free survival (RFS) and overall survival (OS) was 77 and 82% in the elderly and 86 and 93% in the young patients, respectively. Patients with estrogen receptor (ER)-positive or lymph node (LN)-negative cancers showed a more favorable outcome in the elderly patients. RFS and OS were increased in elderly patients who underwent endocrine therapy or omitted chemotherapy. Breast cancer in the elderly had more favorable tumor features, using estrogen receptor and lymph node status as prognostic factors. It was therefore concluded that adjuvant endocrine therapy may benefit elderly patients, while chemotherapy may not.
本研究旨在确定中国老年乳腺癌患者的临床病理特征及治疗敏感性。收集了594例年龄在70岁及以上的老年乳腺癌患者的临床资料,并与657例年龄小于70岁的患者进行比较,以分析老年乳腺癌是否存在差异以及该差异是否影响预后。老年患者的中位年龄为75.2岁,年轻患者为49.8岁。两组的初潮年龄、生育状况和体重指数相似。70岁及以上患者的类固醇受体阳性率较高、HER-2和p53表达较低、腋窝淋巴结阳性率较低且肿瘤分期较早。老年患者的5年无复发生存率(RFS)和总生存率(OS)分别为77%和82%,年轻患者分别为86%和93%。雌激素受体(ER)阳性或淋巴结(LN)阴性癌症患者在老年患者中预后更良好。接受内分泌治疗或未进行化疗的老年患者的RFS和OS有所提高。以雌激素受体和淋巴结状态作为预后因素,老年乳腺癌具有更有利的肿瘤特征。因此得出结论,辅助内分泌治疗可能使老年患者获益,而化疗可能并非如此。