Geriatric assessment for older patients with breast cancer: A single-institution study
IntroductionAlthough geriatric assessment (GA) has been used for a long time in the field of geriatrics and internal medicine, there are few studies on its application in the field of breast surgery. Therefore, the utility of specific GA domains for the assessment of older patients with breast cance...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1031682/full |
| _version_ | 1797896151277502464 |
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| author | Yan Lin Ying Xu Changjun Wang Yu Song Yali Xu Xiaohui Zhang Xin Huang Qiang Sun |
| author_facet | Yan Lin Ying Xu Changjun Wang Yu Song Yali Xu Xiaohui Zhang Xin Huang Qiang Sun |
| author_sort | Yan Lin |
| collection | DOAJ |
| description | IntroductionAlthough geriatric assessment (GA) has been used for a long time in the field of geriatrics and internal medicine, there are few studies on its application in the field of breast surgery. Therefore, the utility of specific GA domains for the assessment of older patients with breast cancer remains unclear. The aim of the present study was to evaluate the association between specific GA domains and the survival rate of older patients with breast cancer.MethodsWe used the database of Peking Union Medical College Hospital to identify older patients who were newly diagnosed with breast cancer between 2012 and 2018 and retrospectively analysed the data of 541 patients aged ≥65 years. Patients with metastatic cancer and those with missing vital status data were excluded. The primary outcomes were overall survival (OS) and breast cancer-specific survival. The GA domains used in this study included functional status, comorbidities, and psychological state. Multivariate regression analysis was used to estimate hazard ratios for these three domains.ResultsAfter a median follow-up of 72 months, we observed a significant relationship between functional impairment and mortality (adjusted HR: 3.06, 95% confidence interval [CI]: 1.83-5.10, P<0.001). Similarly, patients with severe comorbidities (adjusted HR: 2.35; 95% CI: 1.16-4.75, P=0.017) and an impaired psychological state (adjusted HR: 2.82, 95% CI: 1.45-5.50, P=0.002) showed worse OS rates. Accordingly, addition of the three GA domains to the basic model, which included age, tumour stage, lymph node stage, and intrinsic molecular subtype as baseline variables, yielded higher C‐statistics for mortality analysis (from 0.713 to 0.740).ConclusionTo our knowledge, this is the first study to include specific GA domains in a prognostic model for older patients with breast cancer in China. Three domains, namely functional status, comorbidities, and psychological state, should be considered for survival analyses in this particular population. The full model including these three GA domains may be more accurate in predicting the survival of older patients with breast cancer. |
| first_indexed | 2024-04-10T07:38:18Z |
| format | Article |
| id | doaj.art-c7625dd0c2c04b108c7be68e41f46ee3 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T07:38:18Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-c7625dd0c2c04b108c7be68e41f46ee32023-02-23T12:29:55ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-02-011310.3389/fonc.2023.10316821031682Geriatric assessment for older patients with breast cancer: A single-institution studyYan LinYing XuChangjun WangYu SongYali XuXiaohui ZhangXin HuangQiang SunIntroductionAlthough geriatric assessment (GA) has been used for a long time in the field of geriatrics and internal medicine, there are few studies on its application in the field of breast surgery. Therefore, the utility of specific GA domains for the assessment of older patients with breast cancer remains unclear. The aim of the present study was to evaluate the association between specific GA domains and the survival rate of older patients with breast cancer.MethodsWe used the database of Peking Union Medical College Hospital to identify older patients who were newly diagnosed with breast cancer between 2012 and 2018 and retrospectively analysed the data of 541 patients aged ≥65 years. Patients with metastatic cancer and those with missing vital status data were excluded. The primary outcomes were overall survival (OS) and breast cancer-specific survival. The GA domains used in this study included functional status, comorbidities, and psychological state. Multivariate regression analysis was used to estimate hazard ratios for these three domains.ResultsAfter a median follow-up of 72 months, we observed a significant relationship between functional impairment and mortality (adjusted HR: 3.06, 95% confidence interval [CI]: 1.83-5.10, P<0.001). Similarly, patients with severe comorbidities (adjusted HR: 2.35; 95% CI: 1.16-4.75, P=0.017) and an impaired psychological state (adjusted HR: 2.82, 95% CI: 1.45-5.50, P=0.002) showed worse OS rates. Accordingly, addition of the three GA domains to the basic model, which included age, tumour stage, lymph node stage, and intrinsic molecular subtype as baseline variables, yielded higher C‐statistics for mortality analysis (from 0.713 to 0.740).ConclusionTo our knowledge, this is the first study to include specific GA domains in a prognostic model for older patients with breast cancer in China. Three domains, namely functional status, comorbidities, and psychological state, should be considered for survival analyses in this particular population. The full model including these three GA domains may be more accurate in predicting the survival of older patients with breast cancer.https://www.frontiersin.org/articles/10.3389/fonc.2023.1031682/fullbreast cancerolder patientsgeriatric analysissurvival ratesurvival model |
| spellingShingle | Yan Lin Ying Xu Changjun Wang Yu Song Yali Xu Xiaohui Zhang Xin Huang Qiang Sun Geriatric assessment for older patients with breast cancer: A single-institution study Frontiers in Oncology breast cancer older patients geriatric analysis survival rate survival model |
| title | Geriatric assessment for older patients with breast cancer: A single-institution study |
| title_full | Geriatric assessment for older patients with breast cancer: A single-institution study |
| title_fullStr | Geriatric assessment for older patients with breast cancer: A single-institution study |
| title_full_unstemmed | Geriatric assessment for older patients with breast cancer: A single-institution study |
| title_short | Geriatric assessment for older patients with breast cancer: A single-institution study |
| title_sort | geriatric assessment for older patients with breast cancer a single institution study |
| topic | breast cancer older patients geriatric analysis survival rate survival model |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1031682/full |
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