Geriatric Breast Cancer In Alexandria, Egypt Past, Present and, Future
Geriatric Breast Cancer In Alexandria, Egypt Past, Present and, Future.
ElAlfy E, Salah Abdelmoneim, Abdelmoneim NA
Conference: BGICC conference, At Cairo, Volume: 5th
محتويات
ABSTRACT[عدل]
Introduction[عدل]
The latest Egyptian population census by Central Agency for Public Mobilization And Statistics (CAPMAS) has forecasted that the percentage of elderly over the age of 65 will be changing dramatically over the next 20-30 years (yrs). Currently; Egyptians with age of 65 and above constitute 4.32% of the population, 3.6 million individuals. More than 60% of cancer cases are diagnosed in patients older than the age of 65 yrs. Elderly patients are infrequently included in clinical trials. There are few data regarding the efficacy of chemotherapy in breast cancer patients older than age 65 yrs, and in clinical practice, older women with early-stage breast cancer receive adjuvant chemotherapy less frequently than do their younger counterparts.
Purpose[عدل]
To assess comorbidity, hormone receptor status and the effect of chemotherapy plus Hormonal Therapy on disease-free and overall survival (DFS and OS) in breast cancer patients equal to and, older than 65 years old relative to Hormonal Therapy alone in comparison with younger patients aging from 60 to 64 years old in a single cancer center in Alexandria Region, Egypt.
Patients and methods[عدل]
This retrospective study was conducted on all (357) pathologically confirmed breast cancer patients who were divided into two groups (gp); gp I (194 pts) aging from 60-64 yrs and gp II (163 pts) of age 65 yrs and older, Comorbidity in the form of DM, HTN or, both was commoner in gp II than gp I 56.4% vs 44.3%, respectively; p_ .023. High +ve Hormonal receptors were dominant in both two groups. The ER +ve was 88.7% in gp I, compared to 85.9% in gp II; p_.432. The PgR +ve was 80.4% in gp I, compared to 78.5% in gp II; p_.660. Loco-regional radiotherapy was done in 60.8% & 39.3% of gps I & II respectively, p<.001 (OR, 0.416; 95% CI, 0.272 to 0.638). Chemotherapy (Anthracycline based or, CMF) were used in 69.1% and 50.3% of gps I & II, respectively; p<.001. Chemotherapy then Hormonal Therapy was used in 53.1% & 36.8% of gps I & II, respectively; p_.002. 30.9% and 49.7% in gps I & II received Hormonal Therapy alone; p<.001. Chemotherapy alone subjects were 16% in gp I and 13.5% in gp II; p_001. This study of adjuvant treatment was performed in subjects from Cancer Management and Research Department, Medical Research Institute, Alexandria University from January 1995 to December 2010. Clinicopathological parameters, treatment details and time-to- failure were registered.
Results[عدل]
In the study of survivorship as 5-yr-DFS and, 5-yrs-OS; DFS was 58.8% & 55.8% in gps I & II, respectively; p_.576. Among the subjects who received chemotherapy then Hormonal Therapy; DFS as 45.4% in comparison to 46.1% with metastasis in both two groups, p_.898, (Odds Ratio [OR], 0.973; 95% CI, 0.638 to 1.482). While it was 43.4% & 34.2% respectively; p_.079, (OR, 1.475; 95% CI, 0.956 to 2.278) among those who received Hormonal Therapy alone. OS was 49.6% & 38.0% in both two gps I & II; p_.038; (OR, 1.603; 95% CI, 1.025 to 2.507), among those who received chemotherapy then Hormonal Therapy, while it was 41.5% & 35.5% in gp I & gp II, respectively; p_.273; among those who received Hormonal Therapy alone.
Conclusion[عدل]
OS in senior pts younger than 65 yrs was better than in older pts. OS was lower in the presence of one or more of comorbidity risk factors. Pts who received both adjuvant chemotherapy then hormonal therapy experienced better OS than those who received adjuvant hormonal therapy alone.
Key words[عدل]
Breast cancer, Hormonal therapy, senior patients, Egypt.
Geriatric Breast Cancer In Alexandria, Egypt Past, Present and, Future. (PDF Download Available). Available from: http://www.researchgate.net/publication/232715784_Geriatric_Breast_Cancer_In_Alexandria_Egypt_Past_Present_and_Future [accessed Sep 11, 2015].
