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Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study

PURPOSE: There is an ongoing discussion about ‘undertreatment’ of breast cancer in elderly patients. Due to low accrual into clinical trials, level 1 evidence is scarce. We report prospective data of elderly patients with breast cancer treated by medical oncologists in Germany. METHODS: The SENORA p...

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Autores principales: Fietz, Thomas, Zahn, Mark-Oliver, Köhler, Andreas, Engel, Erik, Frank, Melanie, Kruggel, Lisa, Jänicke, Martina, Marschner, Norbert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790852/
https://www.ncbi.nlm.nih.gov/pubmed/29030786
http://dx.doi.org/10.1007/s10549-017-4534-8
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author Fietz, Thomas
Zahn, Mark-Oliver
Köhler, Andreas
Engel, Erik
Frank, Melanie
Kruggel, Lisa
Jänicke, Martina
Marschner, Norbert
author_facet Fietz, Thomas
Zahn, Mark-Oliver
Köhler, Andreas
Engel, Erik
Frank, Melanie
Kruggel, Lisa
Jänicke, Martina
Marschner, Norbert
author_sort Fietz, Thomas
collection PubMed
description PURPOSE: There is an ongoing discussion about ‘undertreatment’ of breast cancer in elderly patients. Due to low accrual into clinical trials, level 1 evidence is scarce. We report prospective data of elderly patients with breast cancer treated by medical oncologists in Germany. METHODS: The SENORA project within the prospective cohort study TMK (Tumour Registry Breast Cancer) was conducted in 82 centres from 2007–2015. Among 2316 patients, half were enrolled with curative and half with palliative treatment intention. Overall, 478 patients (21%) were aged ≥ 70. RESULTS: In the adjuvant setting, elderly patients aged ≥ 70 had more advanced tumour stages at diagnosis and a higher prevalence of comorbidities than younger patients. Elderly patients received adjuvant chemotherapy less frequently, yet the 3-year disease-free survival was similar (86% vs. 88%). In the palliative setting, elderly patients more frequently received endocrine therapy and less frequently chemotherapy. Their median overall survival [24.9 months, 95% CI (confidence interval) 20.0–30.2] was significantly shorter than that of younger patients (39.7 months, 95% CI 34.9–44.2). A Cox proportional hazards model showed a significantly increased risk of mortality for: age ≥ 70 at start of therapy, negative HR- or HER2-status, higher number of metastatic sites, more comorbidities and high tumour grading at diagnosis. CONCLUSIONS: Our results shed light on the routine treatment of elderly patients with breast cancer. A regression model demonstrated that age is but one of various prognostic factors determining the shorter overall survival of elderly patients.
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spelling pubmed-57908522018-02-05 Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study Fietz, Thomas Zahn, Mark-Oliver Köhler, Andreas Engel, Erik Frank, Melanie Kruggel, Lisa Jänicke, Martina Marschner, Norbert Breast Cancer Res Treat Epidemiology PURPOSE: There is an ongoing discussion about ‘undertreatment’ of breast cancer in elderly patients. Due to low accrual into clinical trials, level 1 evidence is scarce. We report prospective data of elderly patients with breast cancer treated by medical oncologists in Germany. METHODS: The SENORA project within the prospective cohort study TMK (Tumour Registry Breast Cancer) was conducted in 82 centres from 2007–2015. Among 2316 patients, half were enrolled with curative and half with palliative treatment intention. Overall, 478 patients (21%) were aged ≥ 70. RESULTS: In the adjuvant setting, elderly patients aged ≥ 70 had more advanced tumour stages at diagnosis and a higher prevalence of comorbidities than younger patients. Elderly patients received adjuvant chemotherapy less frequently, yet the 3-year disease-free survival was similar (86% vs. 88%). In the palliative setting, elderly patients more frequently received endocrine therapy and less frequently chemotherapy. Their median overall survival [24.9 months, 95% CI (confidence interval) 20.0–30.2] was significantly shorter than that of younger patients (39.7 months, 95% CI 34.9–44.2). A Cox proportional hazards model showed a significantly increased risk of mortality for: age ≥ 70 at start of therapy, negative HR- or HER2-status, higher number of metastatic sites, more comorbidities and high tumour grading at diagnosis. CONCLUSIONS: Our results shed light on the routine treatment of elderly patients with breast cancer. A regression model demonstrated that age is but one of various prognostic factors determining the shorter overall survival of elderly patients. Springer US 2017-10-13 2018 /pmc/articles/PMC5790852/ /pubmed/29030786 http://dx.doi.org/10.1007/s10549-017-4534-8 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Epidemiology
Fietz, Thomas
Zahn, Mark-Oliver
Köhler, Andreas
Engel, Erik
Frank, Melanie
Kruggel, Lisa
Jänicke, Martina
Marschner, Norbert
Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study
title Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study
title_full Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study
title_fullStr Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study
title_full_unstemmed Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study
title_short Routine treatment and outcome of breast cancer in younger versus elderly patients: results from the SENORA project of the prospective German TMK cohort study
title_sort routine treatment and outcome of breast cancer in younger versus elderly patients: results from the senora project of the prospective german tmk cohort study
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790852/
https://www.ncbi.nlm.nih.gov/pubmed/29030786
http://dx.doi.org/10.1007/s10549-017-4534-8
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