Medical Oncology Department, Hospital Universitario Dr. Peset, Avda Gaspar Aguilar 90, 46017, Valencia, Spain.
GEICAM, Spanish Breast Cancer Group, Madrid, Spain.
Clin Transl Oncol. 2019 Dec;21(12):1746-1753. doi: 10.1007/s12094-019-02189-6. Epub 2019 Aug 5.
An increase in the number of cancer cases is expected in the near future. Breast cancer (BC) mortality rates increase with age even when adjusted for other variables. Here we analyzed BC disease-free survival (BCDFS) and BC specific survival (BCSS) in the El Alamo III BC registry of GEICAM Spanish Breast Cancer Group.
El Alamo III is a retrospective registry of BC patients diagnosed between 1998 and 2001. Patients with stage I-III invasive BC of age groups 55-64 years (y), 70-74 years and ≥ 75 years were included. Patients and tumors characteristics, treatments and recurrences and deaths were analyzed.
4343 patients were included within the following age intervals: 2288 (55-64 years), 960 (70-74 years), and 1095 (≥ 75 years). Older patients (≥ 70 years) were diagnosed with more advanced tumors (stage III) than younger patients (21.5% versus 13.4%, p < 0.0001). Mastectomies were performed more on older patients and they received less chemotherapy than younger patients (66.6% versus 43.1%, p < 0.00001 and 30.8% versus 71.6%, p < 0.0001, respectively). With a median follow-up of 5.9 years, 17.7% patients had BCDFS events in the younger group and 19.8% in the older group (p < 0.0001). A decrease in BCSS was also observed in older patients, either when analyzing patients ≥ 70y (p < 0.0001) and when differentiating by the two older groups (p < 0.0001).
Our study suggests that older BC patients have worse outcomes what can be a consequence of receiving inadequate adjuvant treatments. Specific trials for these patients are warranted to allow us to treat them with the same scientific rigor than younger patients.
预计未来癌症病例数量将会增加。即使在调整了其他变量后，乳腺癌（BC）的死亡率仍会随着年龄的增长而上升。在这里，我们分析了西班牙癌症研究治疗组 GEICAM 的 El Alamo III BC 注册中心的 BC 无病生存（BCDFS）和 BC 特异性生存（BCSS）。
El Alamo III 是一项回顾性的 BC 患者注册研究，于 1998 年至 2001 年期间诊断。纳入年龄组为 55-64 岁、70-74 岁和≥75 岁的 I-III 期浸润性 BC 患者。分析了患者和肿瘤特征、治疗和复发以及死亡情况。
4343 名患者纳入以下年龄区间：2288 名（55-64 岁）、960 名（70-74 岁）和 1095 名（≥75 岁）。年龄较大的患者（≥70 岁）比年龄较小的患者诊断为更晚期的肿瘤（III 期）（21.5%比 13.4%，p<0.0001）。年龄较大的患者更倾向于接受乳房切除术，且接受的化疗少于年龄较小的患者（66.6%比 43.1%，p<0.00001 和 30.8%比 71.6%，p<0.0001）。中位随访 5.9 年后，年轻组中有 17.7%的患者发生 BCDFS 事件，而老年组中有 19.8%的患者发生 BCDFS 事件（p<0.0001）。在分析≥70 岁的患者（p<0.0001）和区分两个老年组（p<0.0001）时，也观察到 BCSS 下降。
我们的研究表明，老年 BC 患者的预后较差，这可能是由于接受了不充分的辅助治疗所致。需要为这些患者进行专门的试验，以使我们能够以与年轻患者相同的科学严谨性对其进行治疗。
