内容紹介
Summary
This study compared the treatment results of over 80-year-old(O-80) 54 and 157 septuagenarian(70s)women with breast cancer(BC)from 1996 to 2015, to clarify the best treatment option for O-80BC patients. No differences were observed in the stages and subtypes. More than 70% of women in both groups underwent breast-conserving surgery(BCS), and 48.1% and 12.1% of O-80BC and 70sBC patients did not undergo axillary dissection, respectively. About 3.2% and 18.5% of 70sBC and O-80BC patients did not receive adjuvant therapies, respectively. Most ER-positive patients in both groups received endocrine therapy. Most patients in both groups received no intravenous chemotherapy; however, oral chemotherapy was administered in 80.3% of 70sBC and 64.8% of O-80BC patients. Approximately 75.2% of 70sBC and 11.1% of O-80BC patients received post-surgical radiotherapy(RT). No differences in both relapse-free survival and overall survival(OS)rates were observed between the 2 groups. Breast cancer-related death(57.1%)and natural death from old age(57.1%)were the most commonly observed cause of death in the 70sBC and O-80BC groups, respectively. Multivariate analyses on OS demonstrated that BCS and intravenous chemotherapy were significantly associated with poor prognosis and RT was significantly associated with better prognosis in 70sBC group, whereas BCS was significantly associated with better prognosis in O-80BC group. In conclusion, surgery, especially BCS, plays an important role in the primary treatment of O-80BC patients; however, axillary dissection, RT, endocrine therapy, and chemotherapy cannot be performed.
要旨
80歳超乳癌(O-80BC)手術症例の治療と予後を70歳台乳癌(70sBC)と後ろ向きに比較検討した。対象は,1996～2015年のO-80BC切除54例と70sBC切除157例で,両群のStage,subtypeに差はなかった。温存手術(BCS)率に差はなく,腋窩郭清省略は70sBCで12.1%に対し,O-80BCでは約半数(48.1%)であった。術後無治療は70sBCで3.2%に対しO-80BCでは18.5%であった。内分泌療法は両群ともER(+)例では大半が投与され,静注化学療法(化療)は両群とも投与頻度が低く,経口化療は70sBCで80.3%に対し,O-80BCで64.8%であった。術後放射線療法(RT)は70sBCが75.2%に対し,O-80BCは11.1%と少なかった。無再発生存率,全生存率とも両群に差がなかったが,死因は70sBCではBC関連死が最も多く(57.1%),O-80BCは老衰死が最も多かった(57.1%)。多変量解析は70sBCではBCS,静注化療が有意予後不良変数で術後RTが有意予後改善変数であった。O-80BCではBCSが有意予後改善変数であった。以上,O-80BCの治療では手術療法はBCSが基本,腋窩郭清やRTは省略可能,術後の内分泌療法は問題なく投与できるが,術後化療は省略可能で,進行例でも経口化療の投与で十分と思われた。
目次
This study compared the treatment results of over 80-year-old(O-80) 54 and 157 septuagenarian(70s)women with breast cancer(BC)from 1996 to 2015, to clarify the best treatment option for O-80BC patients. No differences were observed in the stages and subtypes. More than 70% of women in both groups underwent breast-conserving surgery(BCS), and 48.1% and 12.1% of O-80BC and 70sBC patients did not undergo axillary dissection, respectively. About 3.2% and 18.5% of 70sBC and O-80BC patients did not receive adjuvant therapies, respectively. Most ER-positive patients in both groups received endocrine therapy. Most patients in both groups received no intravenous chemotherapy; however, oral chemotherapy was administered in 80.3% of 70sBC and 64.8% of O-80BC patients. Approximately 75.2% of 70sBC and 11.1% of O-80BC patients received post-surgical radiotherapy(RT). No differences in both relapse-free survival and overall survival(OS)rates were observed between the 2 groups. Breast cancer-related death(57.1%)and natural death from old age(57.1%)were the most commonly observed cause of death in the 70sBC and O-80BC groups, respectively. Multivariate analyses on OS demonstrated that BCS and intravenous chemotherapy were significantly associated with poor prognosis and RT was significantly associated with better prognosis in 70sBC group, whereas BCS was significantly associated with better prognosis in O-80BC group. In conclusion, surgery, especially BCS, plays an important role in the primary treatment of O-80BC patients; however, axillary dissection, RT, endocrine therapy, and chemotherapy cannot be performed.
要旨
80歳超乳癌(O-80BC)手術症例の治療と予後を70歳台乳癌(70sBC)と後ろ向きに比較検討した。対象は,1996～2015年のO-80BC切除54例と70sBC切除157例で,両群のStage,subtypeに差はなかった。温存手術(BCS)率に差はなく,腋窩郭清省略は70sBCで12.1%に対し,O-80BCでは約半数(48.1%)であった。術後無治療は70sBCで3.2%に対しO-80BCでは18.5%であった。内分泌療法は両群ともER(+)例では大半が投与され,静注化学療法(化療)は両群とも投与頻度が低く,経口化療は70sBCで80.3%に対し,O-80BCで64.8%であった。術後放射線療法(RT)は70sBCが75.2%に対し,O-80BCは11.1%と少なかった。無再発生存率,全生存率とも両群に差がなかったが,死因は70sBCではBC関連死が最も多く(57.1%),O-80BCは老衰死が最も多かった(57.1%)。多変量解析は70sBCではBCS,静注化療が有意予後不良変数で術後RTが有意予後改善変数であった。O-80BCではBCSが有意予後改善変数であった。以上,O-80BCの治療では手術療法はBCSが基本,腋窩郭清やRTは省略可能,術後の内分泌療法は問題なく投与できるが,術後化療は省略可能で,進行例でも経口化療の投与で十分と思われた。