Radiation Oncology Department, Instituto de Radiomedicina (IRAM), Avenida Américo Vespucio 1314, Vitacura, 7630000, Santiago de Chile, Chile.
Facultad de Medicina, Universidad Diego Portales, Santiago, Chile.
Clin Transl Oncol. 2022 Sep;24(9):1800-1808. doi: 10.1007/s12094-022-02836-5. Epub 2022 Apr 27.
Breast cancer (BC) prevalence steadily increases in older patients but their treatment is based on the geriatric evaluations of comorbidities and potential benefits proved in clinical trials with younger patients. The lack of better decision-making tools urges to promote the search for new prognostic markers. The association between inflammation, aging and cancer may be crucial for better treatment selection. We sought to analyze its impact on the survival of older BC patients, evaluating the interaction with age and comorbidities.
We evaluated the relationship between inflammatory biomarkers at BC diagnosis (circulating blood cell counts and inflammatory indexes) and BC-related and not related mortality rate, evaluating the influence of comorbidities and age through the competitive risks assessment.
We analyzed 148 consecutive BC patients aged ≥ 70 years old, diagnosed with BC and regional lymph node metastases. After the median follow-up of 51.5 months, 59 patients died (28 due to breast cancer progression and 31 because of other causes). Increased levels of circulating monocytes, neutrophils and neutrophil-to-lymphocytes ratio and decreased level of eosinophils and eosinophil multiple by neutrophils-to-lymphocytes ratio were associated with higher probability of BC-related death but not with death related to other causes.
Our data suggest a role of inflammatory parameters as a possible prognostic tool in therapeutic decision-making process in older patients with BC, as increased level of inflammation was associated with cancer-specific mortality. Prospective studies may give the possibility of refining the geriatric evaluation for BC treatment in elderly.
乳腺癌（BC）在老年患者中的发病率稳步上升，但他们的治疗是基于对合并症的老年评估和在年轻患者中进行的临床试验中证明的潜在益处。缺乏更好的决策工具促使人们寻求新的预后标志物。炎症、衰老和癌症之间的联系可能对更好的治疗选择至关重要。我们试图分析其对老年 BC 患者生存的影响，评估其与年龄和合并症的相互作用。
我们评估了 BC 诊断时炎症生物标志物（循环血细胞计数和炎症指标）与 BC 相关和非相关死亡率之间的关系，通过竞争风险评估评估了合并症和年龄的影响。
我们分析了 148 名年龄≥70 岁的连续 BC 患者，这些患者被诊断为 BC 和区域淋巴结转移。在中位随访 51.5 个月后，59 名患者死亡（28 名死于乳腺癌进展，31 名死于其他原因）。循环单核细胞、中性粒细胞和中性粒细胞与淋巴细胞比值升高，嗜酸性粒细胞和嗜酸性粒细胞与中性粒细胞比值降低与 BC 相关死亡的概率增加相关，但与其他原因导致的死亡无关。
我们的数据表明，炎症参数作为一种可能的预后工具，在老年 BC 患者的治疗决策过程中具有重要作用，因为炎症水平的增加与癌症特异性死亡率相关。前瞻性研究可能为老年 BC 患者的治疗提供更精确的老年评估。
