Tumor characteristics and clinical outcome of elderly women with breast cancer
Tumor characteristics and clinical outcome of elderly women with breast cancer
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DOI：
10.1093/jnci/92.7.550
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发表时间：
2000-04-05
期刊：
影响因子：
--
通讯作者：
Clark, GM
中科院分区：
文献类型：
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作者：
Diab, SG;Elledge, RM;Clark, GM
背景：老年乳腺癌患者的数量正在增加。关于这种疾病的有限的年龄相关信息促使了这项研究。患者目的方法：研究人群分别来自圣安东尼奥乳腺癌数据库和监测、流行病学和最终结果（SEER）登记处的50 828例和256 287例浸润性乳腺癌患者。根据患者年龄分析肿瘤生物学和临床特征、局部和全身治疗以及生存率。还将生存率与普通人群中年龄匹配的女性进行了比较。结果如下：在55岁或55岁以上的患者中，诊断时年龄的增加与肿瘤更有利的生物学特征之间存在关联，包括更多表达类固醇受体的肿瘤，较低的增殖率，二倍体，正常p53，以及缺乏表皮生长因子受体和c-erbB 2的表达。在淋巴结阴性疾病和/或小肿瘤的老年患者中，观察到的和预期的生存率几乎相同。在SEER登记研究中，淋巴结阴性患者的8年生存率相对于一般人群中年龄匹配的妇女的预期生存率为1.01（95%置信区间[CI] = 0.98-1.04），70-74岁患者，1.06（95% CI = 1.01-1.11），80-84岁患者为1.09（95% CI = 0.98-1.20）。结论：对于55岁或以上的女性，年龄的增加与更有利的肿瘤生物学相关，无论疾病状态如何，老年女性的乳腺癌生存率与一般人群的生存率相似。在老年患者中做出临床决策时，应考虑这种有利的结局。
Background: The number of elderly patients with breast cancer is increasing. Limited age-related information available about this disease prompted this study. Patients aim Methods: The study population was derived from 50 828 and 256 287 patients with invasive breast cancer in San,Antonio breast cancer databases and the Surveillance, Epidemiology, and End Results (SEER) registry, respectively. Tumor biologic and clinical characteristics, local and systemic therapies, and survival according to the patient's age were analyzed. Survival was also compared with that of age-matched women from the general population. Results: In patients 55 years old or older, there was an association between increasing age at diagnosis and the presence of more favorable biologic characteristics of the tumor, including more tumors that express steroid receptors, lower proliferative rates, diploidy, normal p53, and absence of the expression of epidermal growth factor receptor and c-erbB2. In older patients with lymph node-negative disease and/or small tumors, the observed and expected survivals were almost identical. In the SEER registry, the 8-year survival of lymph node-negative patients relative to the expected survival of age-matched women from the general population was 1.01 (95% confidence interval [CI] = 0.98-1.04) for patients 70-74 years old, 1.06 (95% CI = 1.01-1.11) for patients 75-79 years old, and 1.09 (95% CI = 0.98-1.20) for patients 80-84 years old. Conclusion: In women 55 years old or older, advancing age is associated with more favorable tumor biology, and breast cancer survival in older women is similar to survival in the general population irrespective of disease status. This favorable outcome should be considered when making clinical decisions in older patients.