已发表论文

老年乳腺癌患者的治疗策略及预后判断

 

Authors Wang Z, Zhou Z, Li W, Wang W, Xie X, Liu J, Song Y, Dang C, Zhang H

Received 22 December 2017

Accepted for publication 30 May 2018

Published 4 September 2018 Volume 2018:10 Pages 3207—3218

DOI https://doi.org/10.2147/CMAR.S160578

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 4

Editor who approved publication: Dr Luzhe Sun

Objective: The prevalence of breast cancer in elderly women (older than 80 years) is expected to rise more dramatically than its incidence. In this study, we evaluated the evidence for treatment guidelines for elderly breast cancer patients.
Patients and methods: All included patients were enrolled from 2010 to 2013 from the Surveillance, Epidemiology, and End Results (SEER) database. The Akaike information criterion (AIC) and Harrell’s  statistic were used to perform comparisons. In addition, a propensity score analysis was used to avoid bias caused by data selection criteria. Prognostic factors were selected as nomogram parameters to develop a model to predict survival.
Results: A total of 16998 patients included in the SEER database from 2010 to 2013 had breast cancer and fulfilled the study criteria. Of whom, 13007 patients underwent surgery. Overall survival and cancer-specific survival were significantly better in patients who underwent surgery and/or radiotherapy than in those who did not (<0.001). In addition, a nomogram system with a  index of 0.83 and an AIC index of 11112.85 was better able to predict prognoses and estimate cancer-specific survival in elderly patients with breast cancer.
Conclusion: A localized surgical approach might provide better results in elderly breast cancer patients. However, radiotherapy improved cancer-specific survival and overall survival in these patients. In addition, a prognostic nomogram directly quantified patient risk by accounting for various prognostic factors without forming risk groups and was better able to estimate cancer-specific survival.
Keywords: breast cancer, elderly patients, survival, prediction, nomogram




Figure 3 Cancer-specific survival according to the included surgical approach categories.