Early stage breast cancer treatment and outcome of older patients treated in an oncogeriatric care and a standard care setting: an international comparison

Boer, A.Z. de; Water, W. van de; Bastiaannet, E.; Glas, N.A. de; Kiderlen, M.; Portielje, J.E.A.; Extermann, M. (2020)

Article / Letter to editor

Introduction Since older patients with breast cancer are underrepresented in clinical trials, an oncogeriatric approach is advocated to guide treatment decisions. However, the effect on outcomes is unclear. The aim of this study was to compare treatments and outcomes between patients treated in an oncogeriatric and a standard care setting. Methods Patients aged >= 70 years with early stage breast cancer were included. Theoncogeriatric cohortcomprised unselected patients from the Moffitt Cancer Center, and thestandard cohortpatients from a Dutch population-based cohort. Cox models were used to characterize the influence of care setting on recurrence risk and overall mortality. Results Overall, 268 patients were included in the oncogeriatric and 1932 patients in the standard cohort. Patients in the oncogeriatric cohort were slightly younger, had more comorbidity, and received more adjuvant endocrine therapy and chemotherapy. Oncogeriatric care was associated with a lower risk of recurrence, which remained significant after adjustment for patient and tumour characteristics [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.44-0.99]. Oncogeriatric care was also associated with a lower overall mortality, which also remained significant after adjustment for patient and tumour characteristics (HR 0.69, 95% CI 0.55-0.87). Conclusions Patients treated in the oncogeriatric care setting had a lower risk of recurrence, which may be explained by more systemic treatment. Overall mortality was also lower, but other explanations besides care setting could not be ruled out as the cohorts had different patient profiles. Future studies need to clarify the impact of an oncogeriatric approach on outcomes.

• Breast cancer
• Geriatric oncology
• Oncogeriatric care
• Geriatric assessment
• Recurrence risk

• All authors: Boer, A.Z. de; Water, W. van de; Bastiaannet, E.; Glas, N.A. de; Kiderlen, M.; Portielje, J.E.A.; Extermann, M.
• Date: 2020-08-19
• Journal: Breast Cancer Research and Treatment
• Volume: 184
• Pages: 519 - 526
• DOI: doi:10.1007/s10549-020-05860-7
• Link: https://link.springer.com/article/10.1007/s10549-020-05860-7