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The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities

PURPOSE: Studies have suggested a potential role of patient’s co-morbidity in determining the survival outcomes of breast cancer. In this study, we examined the long-term oncologic outcomes in breast cancer patients who underwent curative surgery according to their pre-existing comorbid conditions a...

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Autores principales: Han, Jaihong, Lee, Han-Byoel, Lee, Eun-Shin, Kang, Young Joon, Kim, Yumi, Choi, Jihye, Rhu, Jiyoung, Shin, Hee-Chul, Han, Wonshik, Noh, Dong-Young, Moon, Hyeong-Gon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360250/
https://www.ncbi.nlm.nih.gov/pubmed/28323842
http://dx.doi.org/10.1371/journal.pone.0173721
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author Han, Jaihong
Lee, Han-Byoel
Lee, Eun-Shin
Kang, Young Joon
Kim, Yumi
Choi, Jihye
Rhu, Jiyoung
Shin, Hee-Chul
Han, Wonshik
Noh, Dong-Young
Moon, Hyeong-Gon
author_facet Han, Jaihong
Lee, Han-Byoel
Lee, Eun-Shin
Kang, Young Joon
Kim, Yumi
Choi, Jihye
Rhu, Jiyoung
Shin, Hee-Chul
Han, Wonshik
Noh, Dong-Young
Moon, Hyeong-Gon
author_sort Han, Jaihong
collection PubMed
description PURPOSE: Studies have suggested a potential role of patient’s co-morbidity in determining the survival outcomes of breast cancer. In this study, we examined the long-term oncologic outcomes in breast cancer patients who underwent curative surgery according to their pre-existing comorbid conditions and analyzed the association between the co-morbidity and the use of adjuvant therapies. METHODS: The medical records of 2,501 patients who underwent surgery for primary breast cancer from June 2006 to June 2010 were reviewed retrospectively. The patients were classified into three groups according to preoperative ASA status determined by the anesthesiologists. Clinico-pathologic characteristics and survival outcomes of the patients were compared among the different co-morbidity groups. RESULTS: There were 1,792 (71.6%), 665 (26.6%), and 44 (1.8%) patients in ASA I, II, and III, respectively. Total 95 (3.8%) deaths and 269 (10.8%) recurrences (loco-regional and distant) occurred during the median follow-up period of 71 months. Patients with high comorbidity showed significantly higher rate of deaths (51 (2.8%), 38 (5.7%) and 6 (13.6%) deaths in ASA I, II and III group, respectively, p<0.001). The ASA 3 patients also showed significantly higher rate of breast cancer recurrence when compared to other groups (180 (10.0%), 80 (12.0%) and 9 (20.5%) in ASA I, II, and III, respectively, p = 0.041). Significantly fewer patients in the high co-morbidity group received adjuvant therapies (77 (4.3%), 44 (6.6%) and 8 (18.2%) in ASA I, II, and III, respectively, p<0.001). The increased recurrence of breast cancer in the high morbidity group was mostly seen in patients who did not receive adjuvant therapies. The incidence of serious adverse effect during the adjuvant therapy did not differ according to the co-morbidity conditions. CONCLUSIONS: In this study, high comorbidity was related to increased risk of death and recurrence in breast cancer. The increased risk of recurrence in high co-morbidity group was mostly seen in patients who did not receive adjuvant therapies. Considering the relatively low rates of serious adverse effects in high co-morbidity patients who received adjuvant therapies, active use of adjuvant therapies in selected patients may improve survival outcomes in breast cancer patients with severe co-morbidities.
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spelling pubmed-53602502017-04-06 The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities Han, Jaihong Lee, Han-Byoel Lee, Eun-Shin Kang, Young Joon Kim, Yumi Choi, Jihye Rhu, Jiyoung Shin, Hee-Chul Han, Wonshik Noh, Dong-Young Moon, Hyeong-Gon PLoS One Research Article PURPOSE: Studies have suggested a potential role of patient’s co-morbidity in determining the survival outcomes of breast cancer. In this study, we examined the long-term oncologic outcomes in breast cancer patients who underwent curative surgery according to their pre-existing comorbid conditions and analyzed the association between the co-morbidity and the use of adjuvant therapies. METHODS: The medical records of 2,501 patients who underwent surgery for primary breast cancer from June 2006 to June 2010 were reviewed retrospectively. The patients were classified into three groups according to preoperative ASA status determined by the anesthesiologists. Clinico-pathologic characteristics and survival outcomes of the patients were compared among the different co-morbidity groups. RESULTS: There were 1,792 (71.6%), 665 (26.6%), and 44 (1.8%) patients in ASA I, II, and III, respectively. Total 95 (3.8%) deaths and 269 (10.8%) recurrences (loco-regional and distant) occurred during the median follow-up period of 71 months. Patients with high comorbidity showed significantly higher rate of deaths (51 (2.8%), 38 (5.7%) and 6 (13.6%) deaths in ASA I, II and III group, respectively, p<0.001). The ASA 3 patients also showed significantly higher rate of breast cancer recurrence when compared to other groups (180 (10.0%), 80 (12.0%) and 9 (20.5%) in ASA I, II, and III, respectively, p = 0.041). Significantly fewer patients in the high co-morbidity group received adjuvant therapies (77 (4.3%), 44 (6.6%) and 8 (18.2%) in ASA I, II, and III, respectively, p<0.001). The increased recurrence of breast cancer in the high morbidity group was mostly seen in patients who did not receive adjuvant therapies. The incidence of serious adverse effect during the adjuvant therapy did not differ according to the co-morbidity conditions. CONCLUSIONS: In this study, high comorbidity was related to increased risk of death and recurrence in breast cancer. The increased risk of recurrence in high co-morbidity group was mostly seen in patients who did not receive adjuvant therapies. Considering the relatively low rates of serious adverse effects in high co-morbidity patients who received adjuvant therapies, active use of adjuvant therapies in selected patients may improve survival outcomes in breast cancer patients with severe co-morbidities. Public Library of Science 2017-03-21 /pmc/articles/PMC5360250/ /pubmed/28323842 http://dx.doi.org/10.1371/journal.pone.0173721 Text en © 2017 Han et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Han, Jaihong
Lee, Han-Byoel
Lee, Eun-Shin
Kang, Young Joon
Kim, Yumi
Choi, Jihye
Rhu, Jiyoung
Shin, Hee-Chul
Han, Wonshik
Noh, Dong-Young
Moon, Hyeong-Gon
The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
title The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
title_full The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
title_fullStr The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
title_full_unstemmed The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
title_short The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
title_sort treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360250/
https://www.ncbi.nlm.nih.gov/pubmed/28323842
http://dx.doi.org/10.1371/journal.pone.0173721
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