Mackey Rosewell V, Chandru Kowdley Gopal
Department of Surgery, Saint Agnes Hospital, Baltimore, Maryland, USA.
Am Surg. 2014 Jul;80(7):714-9.
There is a paucity of clinical data available on specific treatment in the oncogeriatric population with breast cancer. The purpose of this study was to evaluate treatment patterns and survival outcomes in the elderly to address any disparities at our community hospital. We retrospectively identified a total of 1749 patients diagnosed and treated for breast cancer at our institution between 2001 and 2011. Patient demographics, surgical treatment, stage of disease, tumor characteristics, adjuvant therapy, and 5-year survival data were obtained from tumor registry records. Comparisons between study groups were made using the Pearson χ(2) test and Student's t test. We found more favorable prognostic makers among women older than 70 years of age. Of the women with lymph node-positive disease, 84 per cent of those younger than 70 years and 33 per cent in the older than 70 years of age study group received chemotherapy. Adjuvant chemotherapy and radiation therapy were more frequently performed in the younger group. Overall 5-year survival was 90 per cent and 71 per cent for younger than 70 years and older than 70 years groups, respectively. Women older than 70 years of age have more favorable breast cancer characteristics compared with younger women and received less aggressive treatment and experienced a higher mortality rate. Prospective trials are needed to assess the impact of aggressive multimodality therapy in this oncogeriatric population.
关于老年乳腺癌患者的特定治疗,目前可用的临床数据较少。本研究的目的是评估老年患者的治疗模式和生存结果,以解决我们社区医院存在的任何差异。我们回顾性地确定了2001年至2011年间在我们机构诊断和治疗的1749例乳腺癌患者。患者人口统计学、手术治疗、疾病分期、肿瘤特征、辅助治疗和5年生存数据均来自肿瘤登记记录。研究组之间的比较采用Pearson χ(2)检验和Student's t检验。我们在70岁以上的女性中发现了更有利的预后指标。在淋巴结阳性疾病的女性中,70岁以下研究组的84%和70岁以上研究组的33%接受了化疗。辅助化疗和放疗在年轻组中更频繁进行。70岁以下和70岁以上组的总体5年生存率分别为90%和71%。与年轻女性相比,70岁以上的女性具有更有利的乳腺癌特征,接受的积极治疗较少,死亡率较高。需要进行前瞻性试验来评估积极的多模式治疗对这一老年肿瘤患者群体的影响。