Examining five- and ten-year survival in older women with breast cancer using cancer-specific geriatric assessment
Menée aux Etats-Unis auprès de 660 participantes âgées de plus de 65 ans, cette étude évalue la survie à 5 et 10 ans de patientes atteintes d’un cancer du sein en utilisant un outil d’évaluation gériatrique spécifique au cancer prenant en compte leurs ressources financières, des facteurs cliniques et psychosociaux
To examine five- and ten-year survival based on cancer-specific geriatric assessment (C-SGA) in older women with early stage breast cancer. We evaluated 660 women ⩾65-years old diagnosed with stage I–IIIA primary breast cancer and attending physician permission to contact in four geographic regions in the United States of America (USA). Data were collected over ten-years of follow-up from consenting women’s medical records, telephone interviews, National Death Index and Social Security Death Index. C-SGA was described by four domains using six measures: socio-demographic (financial resources); clinical (comorbidity, obesity); function (physical function limitations); and psychosocial (general mental health, social support). Survival from all-cause and breast-cancer-specific mortality and receipt of guideline-recommended therapy was assessed for different groups of subjects with C-SGA domain deficits (cut-off ⩾3 deficits). The proportion of women with ⩾3 C-SGA deficits surviving ten-years was consistently statistically significantly lower (all-cause 26% versus 46% and breast-cancer-specific 76% versus 89%, p⩽0.04). The proportion significantly decreased as number of C-SGA deficits increased (linear trend p<0.0001). Receipt of guideline-recommended therapy decreased with age but not consistently by number of C-SGA deficits. The all-cause and breast-cancer-specific death rate at five- and ten-years was consistently approximately two times higher in women with ⩾3 C-SGA deficits even when fully adjusted for confounding factors (HR5-yrAllCauseFullyAdjusted=1.87 [1.36–2.57], HR10-yrAllCauseFullyAdjusted=1.74 [1.35–2.15], HR5-yrBreastCancerFullyAdjusted=1.95 [1.18–3.20], HR10-yrBreastCancerFullyAdjusted=1.99 [1.21–3.28]). Regardless of age and stage of disease, C-SGA predicts five- and ten-year all-cause and breast-cancer-specific survival in older women. Hence, C-SGA may provide an effective strategy to guide treatment decision-making and to identify risk factors for intervention.
http://linkinghub.elsevier.com/retrieve/pii/S0959804911004205?showall=true 2011