Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Medical Center Library, Duke University, Durham, NC 27710, USA.
Medicina (Kaunas). 2023 Aug 30;59(9):1576. doi: 10.3390/medicina59091576.
: Breast cancer is the most common cancer in women, and older patients comprise an increasing proportion of patients with this disease. The older breast cancer population is heterogenous with unique factors affecting clinical decision making. While many models have been developed and tested for breast cancer patients of all ages, tools specifically developed for older patients with breast cancer have not been recently reviewed. We systematically reviewed prognostic models developed and/or validated for older patients with breast cancer. : We conducted a systematic search in 3 electronic databases. We identified original studies that were published prior to 8 November 2022 and presented the development and/or validation of models based mainly on clinico-pathological factors to predict response to treatment, recurrence, and/or mortality in older patients with breast cancer. The PROBAST was used to assess the ROB and applicability of each included tool. : We screened titles and abstracts of 7316 records. This generated 126 studies for a full text review. We identified 17 eligible articles, all of which presented tool development. The models were developed between 1996 and 2022, mostly using national registry data. The prognostic models were mainly developed in the United States ( = 7; 41%). For the derivation cohorts, the median sample size was 213 (interquartile range, 81-845). For the 17 included modes, the median number of predictive factors was 7 (4.5-10). : There have been several studies focused on developing prognostic tools specifically for older patients with breast cancer, and the predictions made by these tools vary widely to include response to treatment, recurrence, and mortality. While external validation was rare, we found that it was typically concordant with interval validation results. Studies that were not validated or only internally validated still require external validation. However, most of the models presented in this review represent promising tools for clinical application in the care of older patients with breast cancer.
乳腺癌是女性最常见的癌症,老年患者在该病患者中的比例不断增加。老年乳腺癌患者群体存在异质性,影响临床决策的因素也各不相同。虽然已经开发和测试了适用于所有年龄段乳腺癌患者的多种模型,但针对老年乳腺癌患者的特定工具尚未得到最新审查。我们系统地回顾了为老年乳腺癌患者开发和/或验证的预后模型。
我们在 3 个电子数据库中进行了系统搜索。我们确定了在 2022 年 11 月 8 日前发表的原始研究,这些研究主要基于临床病理因素,提出了用于预测老年乳腺癌患者对治疗的反应、复发和/或死亡率的模型的开发和/或验证。我们使用 PROBAST 评估每个纳入工具的 ROB 和适用性。
我们筛选了 7316 篇记录的标题和摘要。这产生了 126 项研究进行全文审查。我们确定了 17 篇符合条件的文章,这些文章均介绍了工具的开发。这些模型的开发时间在 1996 年至 2022 年之间,主要使用国家登记数据。这些预后模型主要在美国开发(n=7;41%)。对于推导队列,中位数样本量为 213(四分位距,81-845)。对于 17 种纳入的模式,中位数预测因素数量为 7(4.5-10)。
已经有一些研究专注于为老年乳腺癌患者专门开发预后工具,这些工具的预测结果差异很大,包括对治疗的反应、复发和死亡率。虽然外部验证很少见,但我们发现它通常与间隔验证结果一致。未经过验证或仅内部验证的研究仍需要外部验证。然而,本综述中提出的大多数模型代表了在老年乳腺癌患者护理中具有临床应用前景的有希望的工具。