Older patients with early-stage breast cancer who were treated using an oncogeriatric approach were more likely to receive adjuvant treatments and had improved clinical outcomes compared with patients who were treated with the standard of care, found a retrospective observational study published in Breast Cancer Research and Treatment.
The study included patients 70 years or older at the time of their diagnosis with early-stage breast cancer. and patients were separated into 2 cohorts: an oncogeriatric cohort, in which 268 patients were identified from the Moffitt Cancer Center, Tampa, Florida, and a standard cohort, in which 1932 patients were identified from the Netherlands Cancer Registry.
Patients in the oncogeriatric cohort were treated with an oncogeriatric approach, which included undergoing geriatric screening and assessment and having geriatric oncologists and geriatric nurse practitioners present when patients were discussed at a multidisciplinary meeting.
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By contrast, patients in the standard cohort were treated with the standard of care, which did not include geriatric screening or assessment or having geriatric oncologists and geriatric nurse practitioners present when patient care plans were discussed.
The cohorts had differences, with the oncogeriatric cohort being younger (P <.001), having more comorbidities (P <.001), polypharmacy (P <.001), and lymph node-positive disease (P <.001), and having larger tumors (P =.026) than the standard cohort.
An analysis adjusted for patient and tumor characteristics revealed that the oncogeriatric cohort had a 34% lower risk of recurrence compared with the standard cohort (hazard ratio [HR], 0.66; 95% CI, 0.44–0.99).
The study authors pointed out that this finding “may be explained” by the receipt of more systemic treatment by the oncogeriatric cohort. For example, 74.7% of patients in the oncogeriatric cohort with node-negative disease received adjuvant endocrine therapy compared with 32.2% of patients in the standard cohort (P <.001).
Patients in the oncogeriatric cohort were also more likely to undergo surgery, with only 1 patient (0.4%) forgoing surgery compared with 149 (7.7%) in the standard cohort (P <.001).
An adjusted analysis also showed that the oncogeriatric cohort had a 31% lower risk of mortality compared with the standard cohort (HR, 0.69; 95% CI, 0.55–0.87).
However, given the differences in patient and tumor characteristics between cohorts, the study authors cautioned against “making firm inferences on the effect of care setting on the outcomes.”
Reference
de Boer AZ, van de Water W, Bastiaannet E, et al. Early stage breast cancer treatment and outcome of older patients treated in an oncogeriatric care and a standard care setting: an international comparison. Breast Cancer Res Treat. Published online August 19, 2020. doi:10.1007/s10549-020-05860-7
