Wang Zhi, Zhou Zhangjian, Li Wenxing, Wang Wei, Xie Xin, Liu Jincheng, Song Yongchun, Dang Chengxue, Zhang Hao
Division of Surgical Oncology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China,
Division of Surgery, Shaanxi Tuberculosis Hospital, Changan District, Xi'an, Shaanxi, People's Republic of China.
Cancer Manag Res. 2018 Sep 4;10:3207-3218. doi: 10.2147/CMAR.S160578. eCollection 2018.
The prevalence of breast cancer in elderly women (older than 80 years) is expected to rise more dramatically than its incidence. In this study, we evaluated the evidence for treatment guidelines for elderly breast cancer patients.
All included patients were enrolled from 2010 to 2013 from the Surveillance, Epidemiology, and End Results (SEER) database. The Akaike information criterion (AIC) and Harrell's statistic were used to perform comparisons. In addition, a propensity score analysis was used to avoid bias caused by data selection criteria. Prognostic factors were selected as nomogram parameters to develop a model to predict survival.
A total of 16998 patients included in the SEER database from 2010 to 2013 had breast cancer and fulfilled the study criteria. Of whom, 13007 patients underwent surgery. Overall survival and cancer-specific survival were significantly better in patients who underwent surgery and/or radiotherapy than in those who did not (<0.001). In addition, a nomogram system with a index of 0.83 and an AIC index of 11112.85 was better able to predict prognoses and estimate cancer-specific survival in elderly patients with breast cancer.
A localized surgical approach might provide better results in elderly breast cancer patients. However, radiotherapy improved cancer-specific survival and overall survival in these patients. In addition, a prognostic nomogram directly quantified patient risk by accounting for various prognostic factors without forming risk groups and was better able to estimate cancer-specific survival.
预计老年女性（80岁以上）乳腺癌的患病率上升幅度将超过其发病率。在本研究中，我们评估了老年乳腺癌患者治疗指南的证据。
所有纳入患者均来自2010年至2013年的监测、流行病学和最终结果（SEER）数据库。使用赤池信息准则（AIC）和哈雷尔统计量进行比较。此外，采用倾向评分分析以避免数据选择标准导致的偏差。选择预后因素作为列线图参数以建立预测生存的模型。
2010年至2013年SEER数据库中共有16998例患者患有乳腺癌并符合研究标准。其中，13007例患者接受了手术。接受手术和/或放疗的患者的总生存和癌症特异性生存明显优于未接受手术和/或放疗的患者（<0.001）。此外，一个C指数为0.83且AIC指数为11112.85的列线图系统能够更好地预测老年乳腺癌患者的预后并估计癌症特异性生存。
局部手术方法可能为老年乳腺癌患者带来更好的结果。然而，放疗改善了这些患者的癌症特异性生存和总生存。此外，一种预后列线图通过考虑各种预后因素直接量化患者风险，而无需形成风险组，并且能够更好地估计癌症特异性生存。
