Abstract PS7-47: Real-world treatment patterns in older patients with stage I-III breast cancer: A population-based study
Notice bibliographique
Résumé
Abstract Background: The number of older patients is increasing globally. However, older patients are less likely to be offered participation in clinical trials. We aimed to assess the real-world treatment patterns in older patients with breast cancer and to examine the associations of advancing age with cancer specific survival (CSS) and overall survival (OS). Methods: Patients aged > 65 years and diagnosed with stage I-III breast cancer in a large Canadian province from 2004 to 2017 were identified. Data from administrative sources were linked with the provincial cancer registry. Patients were categorized based on their age at diagnosis: old (65-74 years), older (75-84 years) and oldest (> 85 years). Logistic regression analyses were performed to determine the associations of age with receipt of surgery, chemotherapy, radiotherapy, and hormone treatment. Kaplan-Meier survival curves were plotted to estimate the 5-year CSS and OS. Cox proportional hazards models were constructed to examine the associations of age with CSS and OS, adjusting for stage and treatment. Results: A total of 10,719 older patients were eligible. The median age was 73 (interquartile range, 68-79) years and 99.2% were women. There were 6,057 (56.5%) old, 3,438 (32.1%) older, and 1,224 (11.4%) oldest patients. The oldest patients were more likely to have a higher Charlson comorbidity index (CCI) score (<.001) and present with stage III disease (P<.001). Further, the oldest patients were least likely to be treated with surgery (80.2% vs 98.2%, P<.001), chemotherapy (0.8% vs 24.7%, P<.001), radiotherapy (14.6% vs 56.8%, P<.001) and hormone therapy (41.8% vs 66.8%, P<.001) compared with old women with breast cancer. In multivariable logistic regression analyses, the older and oldest patients had a lower likelihood of surgery (odds ratio [OR], 0.42; 95% confidence interval [CI],0.33-0.53; P<.001 and OR, 0.10; 95% CI, 0.08-0.13; P<.001), chemotherapy (OR, 0.08; 95% CI, 0.06-0.09; P<.001 and OR, 0.01; 95% CI, 0.01-0.02; P<.001), radiotherapy (OR, 0.50; 95% CI, 0.46-0.55; P<.001 and OR, 0.13; 95% CI, 0.11-0.15; P<.001) and hormone treatment (OR, 0.61; 95% CI, 0.56-0.67; P<.001 and OR, 0.31; 95% CI, 0.27-0.35; P<.001). There were 1,504 breast cancer related deaths and 1,845 deaths due to other causes. At a median follow-up of 4.9 years, the 5-year CSS rates were 90.7%, 84.1% and 74.9% (P<.001), while 5-year OS rates were 86.2%, 71.3% and 43.2% (P<.001) for the old, the older and the oldest patients. After adjusting for stage and treatment, advancing age predicted for worse CSS (older; hazards ratio [HR], 1.33; 95% CI, 1.17-1.50; P<.001, oldest; HR, 1.49; 95% CI, 1.26-1.76; P<.001) and worse OS (older; HR, 1.82; 95% CI, 1.67-1.98; P<.001, oldest; HR, 3.13; 95% CI, 2.82-3.48; P<.001). Conclusions: Although all treatment modalities were administered less frequently with advancing age, a more significant decline was noted for adjuvant therapy than surgery. The worse CSS observed in the advanced age groups suggest a potential role for cancer-directed therapy in improving outcomes. Further research should focus on the development of less toxic treatment strategies in geriatric patients with breast cancer. Citation Format: Atul Batra, Shiying Kong, Rodrigo Rigo, Winson Y Cheung. Real-world treatment patterns in older patients with stage I-III breast cancer: A population-based study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-47.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».