Dagmura Hasan, Daldal Emin
Surgical Oncology, Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital, Kütahya, TUR.
General Surgery, Gaziosmanpasa University, Tokat, TUR.
Cureus. 2020 Dec 6;12(12):e11934. doi: 10.7759/cureus.11934.
Introduction The number of octogenarian invasive breast cancer cases is projected to increase, as there is a significant increase in life expectancy. However, no specific treatment guideline has been established so far for this vulnerable group of patients. The aim of the present study was to evaluate the treatment outcomes of octogenarians diagnosed with early and locally advanced invasive breast cancer, to compare those who underwent surgery with conventional treatment and those who did not, and to reveal the potential social factors that may affect their therapy outcomes. Material and methods A total of 78 patients aged 80 and over were included in the study. There was a significant relationship between a patient's social milieu and treatment status (p < 0.001). The relationship between receiving endocrine therapy or surgical treatment was also significant (p = 0.029). Results The surgical treatment rate was 90.9% in survivors, which was significantly lower in those who passed away (37.8%, p < 0.001). According to the log-rank test results, life expectancy was significantly longer in operated patients than in non-operated ones (p < 0.001). The median survival length was 62 months (range: 33.8-90.2) in operated patients 80 years of age and above and 19 months (range: 16.3-21.7) in non-operated ones. The surgical treatment frequency was 15.30 times (range: 4.86-48.21) higher in patients living with family than in patients living alone or in a nursing home. Conclusion Thus, the social milieu of the patients, especially the place of residence, had a major impact on the treatment of the elderly (octogenarians) patients with breast cancer. Surgery and endocrine therapy as an adjuvant treatment were tolerable and had positive impacts on survival.
引言 随着预期寿命显著增加,预计80岁及以上浸润性乳腺癌病例数量将会上升。然而,目前尚未针对这一弱势群体患者制定具体的治疗指南。本研究的目的是评估被诊断为早期和局部晚期浸润性乳腺癌的80岁及以上患者的治疗结果,比较接受手术与传统治疗的患者和未接受手术的患者,并揭示可能影响其治疗结果的潜在社会因素。
材料与方法 本研究共纳入78例80岁及以上患者。患者的社会环境与治疗状况之间存在显著关系(p < 0.001)。接受内分泌治疗或手术治疗之间的关系也很显著(p = 0.029)。
结果 幸存者的手术治疗率为90.9%,去世者的手术治疗率显著较低(37.8%,p < 0.001)。根据对数秩检验结果,接受手术的患者的预期寿命显著长于未接受手术的患者(p < 0.001)。80岁及以上接受手术的患者的中位生存长度为62个月(范围:33.8 - 90.2),未接受手术的患者为19个月(范围:16.3 - 21.7)。与独自生活或住在养老院的患者相比,与家人同住的患者的手术治疗频率高15.30倍(范围:4.86 - 48.21)。
结论 因此,患者的社会环境,尤其是居住地点,对老年(80岁及以上)乳腺癌患者的治疗有重大影响。手术和作为辅助治疗的内分泌治疗是可耐受的,并且对生存有积极影响。