Age-Related Disparity in Immediate Prognosis of Patients with Triple-Negative Breast Cancer: A Population-Based Study from SEER Cancer Registries.
Age-Related Disparity in Immediate Prognosis of Patients with Triple-Negative Breast Cancer: A Population-Based Study from SEER Cancer Registries.
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DOI：
10.1371/journal.pone.0128345
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Xu B
中科院分区：
文献类型：
--
作者：
Zhu W;Perez EA;Hong R;Li Q;Xu B
三阴性乳腺癌（TNBC）已被证实预后不良，但TNBC预后是否存在任何与年龄相关的变化尚未阐明。目前以人群为基础的研究调查了老年妇女TNBC的早期生存模式，并确定了结果相关因素。我们检索了监测、流行病学和最终结果（SEER）数据库，并纳入了女性原发性非转移性TNBC病例。患者又分为老年组（≥70岁）和青年组（<70岁）。比较老年患者与年轻女性的生存状况。主要终点和次要终点分别为癌症特异性生存期（CSS）和总生存期（OS）。本研究纳入了2010年至2011年诊断的9908例女性TNBC患者（20.4%为老年人）。相对晚期疾病的老年患者的癌症特异性（log-rank, p<0.001）和总生存率（log-rank, p<0.001）明显低于年轻患者。高龄诊断（≥70岁）在CSS方面可显著预测不良预后(风险比（HR）， 2.125；95%置信区间（CI）， 1.664 ~ 2.713；p<0.001)和OS （HR, 3.042; 95%CI, 2.474 ~ 3.740; p<0.001）。在II期或III期疾病的老年妇女中，治疗性治疗特别是放疗的使用不足比年轻患者更为普遍。与年轻人相比，老年TNBC患者在诊断后的前两年表现出较高的早期死亡率。观察到的较低的局部区域治疗率可能与这些患者较差的癌症特异性结局有关。
Triple-negative breast cancer (TNBC) has been demonstrated to carry poor prognosis, but whether or not there exists any age-related variation in TNBC outcomes has yet to be elucidated. The current population-based study investigated the early survival pattern of elderly women with TNBC and identified outcome-correlated factors. We searched the Surveillance, Epidemiology, and End Results (SEER) database and enrolled female primary non-metastatic TNBC cases. The patients were subdivided into elderly (≥70 years) and young groups (<70 years). The survival status of elderly patients was compared to that of the younger women. The primary and secondary endpoints were cancer-specific survival (CSS) and overall survival (OS) respectively. 9908 female TNBC patients diagnosed from 2010 to 2011 were included in the current study (20.4% elderly). Elderly patients with relatively advanced diseases exhibited distinctly worse cancer-specific (log-rank, p<0.001) and overall survival (log-rank, p<0.001) than their young counterparts. Advanced age at diagnosis (≥70 years) was significantly predictive of poor outcome in terms of CSS (hazard ratio (HR), 2.125; 95% confidence interval (CI), 1.664 to 2.713; p<0.001) and OS (HR, 3.042; 95%CI, 2.474 to 3.740; p<0.001). Underuse of curative treatment especially radiotherapy was more prevalent in elderly women with stage II or III diseases than in younger patients. Elderly patients with TNBC displayed elevated early mortality within the first two years of diagnosis compared to the younger individuals. The observed lower rate of loco-regional treatment might be associated with worse cancer-specific outcome for these patients.
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