Matched case-control survival analysis of older chinese breast cancer patients treated with surgery or primary endocrine therapy
| Autor: | Ava Kwong, Wing-pan Luk, Ling-hiu Fung, To-ki Dacita Suen |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty Antineoplastic Agents Hormonal Breast Neoplasms primary endocrine therapy surgery 03 medical and health sciences Breast cancer 0302 clinical medicine medicine Humans RC254-282 Survival analysis 030304 developmental biology Aged Aged 80 and over 0303 health sciences business.industry Medical record older chinese patients Confounding Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Comorbidity Survival Analysis Surgery Oncology 030220 oncology & carcinogenesis Case-Control Studies Propensity score matching Cohort Life expectancy case-control matching Female business |
| Zdroj: | Cancer Treatment and Research Communications, Vol 25, Iss, Pp 100227-(2020) |
| ISSN: | 2468-2942 |
| Popis: | Background Primary endocrine therapy (PET) has been used as an alternative to primary surgery for elderly with estrogen receptor (ER) positive breast tumors. Such practices are less commonly performed in Asian countries and the response to PET in Chinese cohort is still lacking. This study aims to compare the clinical outcome of PET to primary surgery. Patients and Methods Medical records of Chinese patients aged 70 and above with stage I to III, ER positive breast cancer treated at a University affiliated tertiary hospital from 2008 to 2017 were reviewed. Excluding those with extreme comorbidity, a one-to-one case-control survival analysis of patients treated with PET or primary operation was performed, using propensity score case-match analysis to adjust for confounding factors. Results 292 patients fulfilled the inclusion criteria during the study period. 209 patients received primary operation, whereas 83 patients received PET. Excluding those with extreme comorbidity, a one-to-one matching was performed, and the dataset was stratified into survival time within 0–5 years and beyond 5 years. Both groups had similar survival within 0–5 years (p = 0.63). The survival curves diverged beyond 5 years, with a significantly better outcome in patients operated than those treated with PET (p = 0.0029). Conclusions For frail older patients with limited life expectancy, PET may be appropriate since equivalent survival can be achieved for PET with or without surgery. Those patients with longer life expectancy may gain survival benefits from local treatment. A comprehensive geriatric assessment is useful to predict the survival probability and guide the optimal treatment. |
| Databáze: | OpenAIRE |
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