Department of Oncology, Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, Sweden.
Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, Sweden.
J Geriatr Oncol. 2021 Mar;12(2):212-218. doi: 10.1016/j.jgo.2020.09.004. Epub 2020 Sep 12.
OBJECTIVES: To study the treatment patterns, potential risk factors for hospitalization within one year from diagnosis, and causes of death in older patients with triple negative breast cancer (TNBC). MATERIALS AND METHODS: We performed a registry-based cohort study using the BCBaSe database which links cases of breast cancer from three Swedish healthcare regions with socioeconomic factors, hospitalizations and causes of death. Women ≥70 years old with non-metastatic TNBC, between 1/12007 and 31/122012 were included (n = 413). RESULTS: In total, 168 patients (40.7%) received chemotherapy after surgery and 123 patients (30.0%) in the whole cohort had at least one hospitalization within one year from diagnosis. The risk of hospitalization overall was increased in the group receiving chemotherapy (Odds Ratio 2.35, 95% Confidence Intervall: 1.30-4.26) mainly due to toxicities. Cumulative incidence of breast cancer mortality was comparable among different age groups (70-74 vs. 75-79 vs. ≥ 80 years old) whereas non-breast cancer mortality was higher in patients ≥80 years old. Stage at diagnosis and comorbidities were independently associated with both breast cancer-specific- and overall mortality whereas age was only associated with overall mortality. CONCLUSIONS: The use of chemotherapy in older patients with TNBC was associated with age, tumor stage, and comorbidities. Chemotherapy use was also associated with increased risk for hospitalization within one year from diagnosis. Although the impact of chemotherapy on mortality was analyzed in a multivariate manner showing neither increased or decreased mortality, no firm conclusion can be drawn due to unmeasured confounders.
目的:研究三阴性乳腺癌(TNBC)老年患者的治疗模式、诊断后一年内住院的潜在危险因素以及死亡原因。
材料和方法:我们使用 BCBaSe 数据库进行了一项基于登记的队列研究,该数据库将来自瑞典三个医疗保健区域的乳腺癌病例与社会经济因素、住院和死亡原因联系起来。纳入年龄≥70 岁、非转移性 TNBC 患者(n=413),发病时间为 2007 年 12 月 1 日至 2012 年 12 月 31 日。
结果:共有 168 例患者(40.7%)在手术后接受化疗,整个队列中有 123 例患者(30.0%)在诊断后一年内至少有一次住院。总体而言,接受化疗的患者住院风险增加(优势比 2.35,95%置信区间:1.30-4.26),主要是由于毒性作用。不同年龄组的乳腺癌死亡率累积发生率相当(70-74 岁 vs. 75-79 岁 vs. ≥80 岁),而非乳腺癌死亡率在≥80 岁的患者中更高。诊断时的分期和合并症与乳腺癌特异性和总死亡率独立相关,而年龄仅与总死亡率相关。
结论:在老年 TNBC 患者中使用化疗与年龄、肿瘤分期和合并症有关。化疗的使用也与诊断后一年内住院风险增加有关。尽管在多变量分析中对化疗对死亡率的影响进行了分析,显示死亡率没有增加或降低,但由于未测量的混杂因素,无法得出确定的结论。
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