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Adjuvant chemotherapy in elderly patients with primary breast cancer: are women ≥65 undertreated?
Wallwiener, C W; Hartkopf, A D; Grabe, E; Wallwiener, M; Taran, F-A; Fehm, T; Brucker, S Y; Krämer, B.
Afiliación
  • Wallwiener CW; Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstraße 7, 72076, Tübingen, Germany. cwallwiener@gmail.com.
  • Hartkopf AD; Department of Women's Health, University of Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany. cwallwiener@gmail.com.
  • Grabe E; Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstraße 7, 72076, Tübingen, Germany.
  • Wallwiener M; Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstraße 7, 72076, Tübingen, Germany.
  • Taran FA; Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
  • Fehm T; Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstraße 7, 72076, Tübingen, Germany.
  • Brucker SY; Department of Obstetrics and Gynecology, University of Duesseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
  • Krämer B; Department of Women's Health, University of Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany.
J Cancer Res Clin Oncol ; 142(8): 1847-53, 2016 Aug.
Article en En | MEDLINE | ID: mdl-27350260
PURPOSE: To establish whether women over 65 years of age with newly diagnosed with breast cancer (BC) receive adjuvant chemotherapy less frequently than younger postmenopausal women and whether comorbidity influences this potential undertreatment. MATERIALS AND METHODS: In a single-site, retrospective, comparative study, postmenopausal early stage BC patients treated between 01/2001 and 12/2005 at a major German university hospital were analyzed in two age Groups A and B (≥65 vs. <65 years) for initiation and completion of guideline-recommended adjuvant chemotherapy. Risk stratification was based on the 2005 St. Gallen Consensus Conference criteria. Comorbidity was parametrized using the Charlson Comorbidity Index (CCI). RESULTS: Analysis included 634 patients, 380 in Group A and 254 in Group B. Mean age (range) was 73 (65-94) and 61 (55-64) years, respectively. The proportion of patients from Group A given ≥3 cycles of chemotherapy was significantly decreased as compared to Group B. 52 % of patients with CCI <3 but only 20 % with CCI ≥3 were recommended to undergo chemotherapy (p < 0.001). Median follow-up [95 % confidence interval (CI)] was 85 (82-88) months. DFS was significantly shorter in patients aged ≥65 years as compared to younger postmenopausal patients (HR, 0.598; 95 % CI, 0.358-0.963; p = 0.048). CONCLUSIONS: Despite being high-risk patients, older women with early stage BC were often not given guideline-recommended chemotherapy. Higher recurrence rates compared with younger postmenopausal women suggest that older patients are undertreated. Treatment needs to be adapted to general health and tumor biology rather than age. More trials in elderly BC patients are needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Quimioterapia Adyuvante Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans Idioma: En Revista: J Cancer Res Clin Oncol Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Quimioterapia Adyuvante Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans Idioma: En Revista: J Cancer Res Clin Oncol Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania