Florian Ebner1, Katharina Hancke2, Maria Blettner3, Lukas Schwentner2, Achim Wöckel4, Rolf Kreienberg2, Wolfgang Janni2, Reyn van Ewijk5. 1. Universität Ulm, Klinik für Frauenheilkunde und Geburtshilfe, Ulm, Germany. Electronic address: florian.ebner@uniklinik-ulm.de. 2. Universität Ulm, Klinik für Frauenheilkunde und Geburtshilfe, Ulm, Germany. 3. Universitätsmedizin derJohannes Gutenberg-Universität Mainz, Institut für Medizinische Biometrie, Epidemiologie und Informatik, Mainz, Germany. 4. Universität Würzburg, Frauenklinik und Poliklinik, Würzburg, Germany. 5. Universitätsmedizin derJohannes Gutenberg-Universität Mainz, Institut für Medizinische Biometrie, Epidemiologie und Informatik, Mainz, Germany; Faculty of Economics, University of Mainz, Mainz, Germany.
Abstract
BACKGROUND: Treatment side effects, comorbidities, and guideline-adherent treatment (GL+) influence the oncologic outcome of older breast cancer patients (oBCP) (age ≥ 70 years). The focus of this analysis was to investigate the associations among tumor characteristics, guideline adherence, and outcome and to compare these associations between younger breast cancer patients (yBCP) (age 50-69 years) and oBCP. METHODS: This is a retrospective multicenter cohort study with 17 participating certified breast cancer centers. The analysis of 10,897 patient records collected from 1992 to 2008 for GL+ and clinical outcome was performed. Tumor and patient characteristics and their associations with GL+ were compared between oBCP and yBCP. RESULTS: Nonguideline-adherent treatment (GL-) was associated with higher tumor stages and comorbidities. This effect was stronger in the oBCP group (P < .001). GL+ was significantly more common in yBCP than in oBCP (P < .001). The oBCP had significantly higher tumor stages, including tumor size (P < .001), nodal status (P < .001), and positive hormone receptors (P = .001). Tumor grading was lower (P = .001), and HER2neu overexpression was less frequent (P = .003) in oBCP. Overall survival and disease-free survival are significantly impaired if GL- occurred in patients with breast cancer independently of age. CONCLUSIONS: GL- is associated with decreased disease-free survival and overall survival in both age groups. GL+ decreases advanced tumor characteristics in all age groups but significantly more in oBCP. If patients received GL+, we were unable to detect a statistical significant difference in the survival parameters.
BACKGROUND: Treatment side effects, comorbidities, and guideline-adherent treatment (GL+) influence the oncologic outcome of older breast cancerpatients (oBCP) (age ≥ 70 years). The focus of this analysis was to investigate the associations among tumor characteristics, guideline adherence, and outcome and to compare these associations between younger breast cancerpatients (yBCP) (age 50-69 years) and oBCP. METHODS: This is a retrospective multicenter cohort study with 17 participating certified breast cancer centers. The analysis of 10,897 patient records collected from 1992 to 2008 for GL+ and clinical outcome was performed. Tumor and patient characteristics and their associations with GL+ were compared between oBCP and yBCP. RESULTS: Nonguideline-adherent treatment (GL-) was associated with higher tumor stages and comorbidities. This effect was stronger in the oBCP group (P < .001). GL+ was significantly more common in yBCP than in oBCP (P < .001). The oBCP had significantly higher tumor stages, including tumor size (P < .001), nodal status (P < .001), and positive hormone receptors (P = .001). Tumor grading was lower (P = .001), and HER2neu overexpression was less frequent (P = .003) in oBCP. Overall survival and disease-free survival are significantly impaired if GL- occurred in patients with breast cancer independently of age. CONCLUSIONS:GL- is associated with decreased disease-free survival and overall survival in both age groups. GL+ decreases advanced tumor characteristics in all age groups but significantly more in oBCP. If patients received GL+, we were unable to detect a statistical significant difference in the survival parameters.
Authors: Ena Niño de Guzmán; Yang Song; Pablo Alonso-Coello; Carlos Canelo-Aybar; Luciana Neamtiu; Elena Parmelli; Javier Pérez-Bracchiglione; Montserrat Rabassa; David Rigau; Zuleika Saz Parkinson; Iván Solà; Adrián Vásquez-Mejía; Ignacio Ricci-Cabello Journal: Breast Cancer Res Treat Date: 2020-05-06 Impact factor: 4.872
Authors: Mia Bierbaum; Jeffrey Braithwaite; Gaston Arnolda; Geoffrey P Delaney; Winston Liauw; Richard Kefford; Yvonne Tran; Bróna Nic Giolla Easpaig; Frances Rapport Journal: BMJ Open Date: 2020-03-23 Impact factor: 2.692
Authors: Ignacio Ricci-Cabello; Adrián Vásquez-Mejía; Carlos Canelo-Aybar; Ena Niño de Guzman; Javier Pérez-Bracchiglione; Montserrat Rabassa; David Rigau; Ivan Solà; Yang Song; Luciana Neamtiu; Elena Parmelli; Zuleika Saz-Parkinson; Pablo Alonso-Coello Journal: BMC Health Serv Res Date: 2020-10-07 Impact factor: 2.655