Annals of surgical oncology · 2026
Practice Patterns and Overall Survival for Octogenarians with Triple Negative Breast Cancer Treated at Accredited Cancer Centers in the USA.
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Mathews Alexandra L, Fan Betty, Pesce Catherine, Kopkash Katherine, Poli Elizabeth, Smith Thomas, Chang Cecilia, Mizera Cecylia, Yao Katharine
Аннотация
BACKGROUND: The purpose of this study was to examine treatment patterns and overall survival (OS) for patients ≥ 80 years with triple negative breast cancer (TNBC).
PATIENTS AND METHODS: The National Cancer Data Base was queried for patients ≥ 80 years old diagnosed with TNBC from 2012 to 2022. Patients with T1a or Tis tumors or distant metastatic disease were excluded. Charlson-Deyo comorbidity scores were used to assess comorbidity burden. Treatment patterns of chemotherapy, radiation therapy, and surgery were examined. OS was estimated using Kaplan-Meier curves and multivariable Cox proportional hazards models evaluated factors associated with OS.
RESULTS: In total, 10,767 patients met inclusion criteria: 5876 (54.5%) were aged 80-84 years, 3296 (30.6%) were 85-89, and 1595 (14.8%) were ≥ 90. Most patients had a Charlson-Deyo score of 0 (69.53%), while 565 patients (5.25%) had scores ≥ 3. Surgery alone was performed in 6916 (64.23%) patients, while 2584 (24.0%) underwent surgery plus chemotherapy, 811 (7.5%) received no treatment, and 284 (2.63%) received chemotherapy alone. Regional lymph nodes were tumor positive in 3001 patients (27.87%). On multivariable analysis, surgery (HR 0.36; 95% CI 0.32-0.41, p < 0.0001) and surgery plus chemotherapy (HR 0.23; 95% CI 0.20-0.27, p < 0.0001) were associated with improved OS when compared with no treatment. At 2.5 years of follow-up, OS was 22.2% for patients who received no treatment, 69.5% for surgery, and 77.6% for surgery plus chemotherapy.
CONCLUSIONS: Surgical management of TNBC in octogenarians is associated with improved OS, with the greatest survival seen in patients undergoing surgery and chemotherapy. These findings are not causal but demonstrate that some octogenarians derive survival benefit from surgery and systemic treatment.
PATIENTS AND METHODS: The National Cancer Data Base was queried for patients ≥ 80 years old diagnosed with TNBC from 2012 to 2022. Patients with T1a or Tis tumors or distant metastatic disease were excluded. Charlson-Deyo comorbidity scores were used to assess comorbidity burden. Treatment patterns of chemotherapy, radiation therapy, and surgery were examined. OS was estimated using Kaplan-Meier curves and multivariable Cox proportional hazards models evaluated factors associated with OS.
RESULTS: In total, 10,767 patients met inclusion criteria: 5876 (54.5%) were aged 80-84 years, 3296 (30.6%) were 85-89, and 1595 (14.8%) were ≥ 90. Most patients had a Charlson-Deyo score of 0 (69.53%), while 565 patients (5.25%) had scores ≥ 3. Surgery alone was performed in 6916 (64.23%) patients, while 2584 (24.0%) underwent surgery plus chemotherapy, 811 (7.5%) received no treatment, and 284 (2.63%) received chemotherapy alone. Regional lymph nodes were tumor positive in 3001 patients (27.87%). On multivariable analysis, surgery (HR 0.36; 95% CI 0.32-0.41, p < 0.0001) and surgery plus chemotherapy (HR 0.23; 95% CI 0.20-0.27, p < 0.0001) were associated with improved OS when compared with no treatment. At 2.5 years of follow-up, OS was 22.2% for patients who received no treatment, 69.5% for surgery, and 77.6% for surgery plus chemotherapy.
CONCLUSIONS: Surgical management of TNBC in octogenarians is associated with improved OS, with the greatest survival seen in patients undergoing surgery and chemotherapy. These findings are not causal but demonstrate that some octogenarians derive survival benefit from surgery and systemic treatment.