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首页> 外文期刊>Medicine. >Impact of lack of surgery on outcomes in elderly women with nonmetastatic breast cancer—A surveillance, epidemiology, and end results 18 population based study
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Impact of lack of surgery on outcomes in elderly women with nonmetastatic breast cancer—A surveillance, epidemiology, and end results 18 population based study

机译：缺乏手术对患有非换乳腺癌的老年妇女成果的影响 - 监测，流行病学和最终结果18个基于人群的研究

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Elderly women with early-stage, nonmetastatic breast cancer do not always receive recommendations for definitive surgical treatment. The reasons vary and include patient and provider-related reasons. We queried the surveillance, epidemiology, and end results database from 2010 to 2013 for women age 60 and older with stage I/II/III invasive breast cancer for whom local treatment was known. We divided the patients into 3 groups: patients for whom surgery was performed; patients for whom surgery was recommended but not performed; patients for whom surgery was not recommended and not performed. We used Kaplan–Meier method to generate OS curves and the Cox proportional hazard test to compare survival outcomes. A total of 119,404 patients were eligible for study with a median age between 70 and 74 years old. Compared with patients who received breast surgery , patients who did not receive surgery had a worse overall survival (OS) (hazard ratio [HR], 7.39; 95% confidence interval [CI], 6.98–7.83, P .001). Patients who were recommended but ultimately did not undergo surgery had better OS than those who were recommended against surgery (adjusted HR, 0.60; 95% CI, 0.53–0.69). However, their survival was significantly inferior to patients who underwent surgery (adjusted HR, 2.81; 95% CI 2.48–3.19). Similar results were found regardless of age, tumor stage, estrogen receptor, or human epidermal growth factor receptor 2 status and were recapitulated in analyses of cancer-specific survival. Upfront definitive breast surgery should be performed in medically-fit elderly patients with early-stage, nonmetastatic breast cancer given significant survival benefit.
机译：早期妇女的妇女，非容性乳腺癌并不总是接受明确手术治疗的建议。原因有所不同，包括患者和提供者的原因。我们为2010年至2013年为2010年和年龄较大的患者询问了2010年至2013年的监测，流行病学和最终结果数据库。我们将患者分为3组：进行手术的患者;推荐手术但未进行患者;不推荐手术的患者而不是进行。我们使用了Kaplan-Meier方法来生成OS曲线和COX比例危险测试以比较生存结果。共有119,404名患者有资格进行学习，中位年龄在70至74岁之间。与接受乳房手术的患者相比，未接受手术的患者的整体存活率更差（os）（危险比[HR]，7.39; 95％置信区间[CI]，6.98-7.83，P <.001）。被推荐但最终没有接受手术的患者具有更好的操作系统，而那些推荐的手术（调整后的HR，0.60; 95％CI，0.53-0.69）。然而，他们的存活率明显不如接受手术的患者（调整的HR，2.81; 95％CI 2.48-3.19）。无论年龄，肿瘤阶段，雌激素受体或人表皮生长因子受体2身份，是否发现了类似的结果，并在癌症特异性存活中综合。预期明确的乳房手术应在术中患有早期的患者的患者中进行，鉴于显着的生存效果。

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