Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ

BackgroundLocal treatment for ductal carcinoma in situ (DCIS) remains controversial for elderly patients. This study aims to evaluate the association of local treatment, clinicopathological factors, and survival in elderly DCIS patients.MethodsPatients ≥ 60 years diagnosed with DCIS from January 200...

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Main Authors: Xu Zhang, Yufei Zeng, Zheng Wang, Xiaosong Chen, Kunwei Shen
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-05-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2023.1074980/full
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author Xu Zhang
Yufei Zeng
Zheng Wang
Xiaosong Chen
Kunwei Shen
author_facet Xu Zhang
Yufei Zeng
Zheng Wang
Xiaosong Chen
Kunwei Shen
author_sort Xu Zhang
collection DOAJ
description BackgroundLocal treatment for ductal carcinoma in situ (DCIS) remains controversial for elderly patients. This study aims to evaluate the association of local treatment, clinicopathological factors, and survival in elderly DCIS patients.MethodsPatients ≥ 60 years diagnosed with DCIS from January 2009 to December 2018 were retrospectively included. Local treatment including breast surgery, axillary lymph node (ALN) surgery, and radiotherapy were analyzed among subgroups (age of 60–69, 70–79, and ≥ 80 years), and their associations with clinicopathological features and prognostic outcome were further evaluated.ResultsA total of 331 patients were included. Eventually 86 patients received breast conserving surgery (BCS) and 245 patients received mastectomy. ALN surgery was omitted in 62 patients. Age and tumor size were independent factors that influenced the breast and ALN surgery (P < 0.05). Compared with patients aging 60–69, patients ≥ 80 years were more likely to receive BCS (OR 4.28, 95% CI 1.33–13.78, P = 0.015) and be exempt from ALN surgery (OR 0.19, 95% CI 0.05–0.69, P = 0.011). Patients with tumor >1.5 cm were significantly less likely to receive BCS (OR 0.45, 95%CI 0.25–0.83, P = 0.011) and more likely to receive ALN surgery (OR 4.41, 95%CI 1.96–10.48, P = 0.001) compared to patients with tumor ≤ 1.5 cm. Postoperative radiotherapy was performed in 48.8% patients who received BCS. Age was the only factor that associated with the radiotherapy decision after BCS in elderly DCIS patients (P = 0.025). No significant recurrence-free survival difference was observed among patients receiving different local treatments.ConclusionsAge was related to the choice of local treatment in elderly DCIS patients, but different treatment patterns didn't impact disease outcome.
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spelling doaj.art-703d6455742f4176afe611bb3e56f1d12023-05-05T05:52:06ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-05-011010.3389/fsurg.2023.10749801074980Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situXu ZhangYufei ZengZheng WangXiaosong ChenKunwei ShenBackgroundLocal treatment for ductal carcinoma in situ (DCIS) remains controversial for elderly patients. This study aims to evaluate the association of local treatment, clinicopathological factors, and survival in elderly DCIS patients.MethodsPatients ≥ 60 years diagnosed with DCIS from January 2009 to December 2018 were retrospectively included. Local treatment including breast surgery, axillary lymph node (ALN) surgery, and radiotherapy were analyzed among subgroups (age of 60–69, 70–79, and ≥ 80 years), and their associations with clinicopathological features and prognostic outcome were further evaluated.ResultsA total of 331 patients were included. Eventually 86 patients received breast conserving surgery (BCS) and 245 patients received mastectomy. ALN surgery was omitted in 62 patients. Age and tumor size were independent factors that influenced the breast and ALN surgery (P < 0.05). Compared with patients aging 60–69, patients ≥ 80 years were more likely to receive BCS (OR 4.28, 95% CI 1.33–13.78, P = 0.015) and be exempt from ALN surgery (OR 0.19, 95% CI 0.05–0.69, P = 0.011). Patients with tumor >1.5 cm were significantly less likely to receive BCS (OR 0.45, 95%CI 0.25–0.83, P = 0.011) and more likely to receive ALN surgery (OR 4.41, 95%CI 1.96–10.48, P = 0.001) compared to patients with tumor ≤ 1.5 cm. Postoperative radiotherapy was performed in 48.8% patients who received BCS. Age was the only factor that associated with the radiotherapy decision after BCS in elderly DCIS patients (P = 0.025). No significant recurrence-free survival difference was observed among patients receiving different local treatments.ConclusionsAge was related to the choice of local treatment in elderly DCIS patients, but different treatment patterns didn't impact disease outcome.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1074980/fullbreast cancerductal carcinoma in situelderlysurgeryradiotherapy
spellingShingle Xu Zhang
Yufei Zeng
Zheng Wang
Xiaosong Chen
Kunwei Shen
Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ
Frontiers in Surgery
breast cancer
ductal carcinoma in situ
elderly
surgery
radiotherapy
title Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ
title_full Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ
title_fullStr Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ
title_full_unstemmed Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ
title_short Associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ
title_sort associations of clinicopathological factors with local treatment and survival outcome in elderly patients with ductal carcinoma in situ
topic breast cancer
ductal carcinoma in situ
elderly
surgery
radiotherapy
url https://www.frontiersin.org/articles/10.3389/fsurg.2023.1074980/full
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AT zhengwang associationsofclinicopathologicalfactorswithlocaltreatmentandsurvivaloutcomeinelderlypatientswithductalcarcinomainsitu
AT xiaosongchen associationsofclinicopathologicalfactorswithlocaltreatmentandsurvivaloutcomeinelderlypatientswithductalcarcinomainsitu
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