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عنوان انگلیسی مقاله:
The use of surgery in the treatment of ER+ early stage breast cancer in England: variation by time, age and patient characteristics
ترجمه فارسی عنوان مقاله:
استفاده از عمل جراحی در درمان ER + سرطان پستان در مراحل اولیه در انگلستان: تنوع توسط زمان، سن و ویژگی های بیمار
Sciencedirect - Elsevier - European Journal of Surgical Oncology, Accepted manuscript. doi:10.1016/j.ejso.2015.12.012
AIM: To assess whether the proportion of patients aged 70 and over with ER+ operable breast
cancer in England who are treated with surgery has changed since 2002, and to determine
whether age and individual level factors including tumour characteristics and co-morbidity
influence treatment choice.
METHODS: A retrospective cohort analysis of routinely collected cancer registration data from two English regions (West Midlands, Northern & Yorkshire) was carried out (n = 17,129). Trends in surgical use over time for different age groups were assessed graphically and with linear regression. Uni- and multivariable logistic regressions were used to assess the effects of age, comorbidity, deprivation and disease characteristics on treatment choice. Missing data was handled using multiple imputation.
RESULTS: There is no evidence of a change in the proportion of patients treated surgically over time. The multivariable model shows that age remains an important predictor of whether or not a woman with ER+ operable breast cancer receives surgery after covariate adjustment (Odds ratio of surgery vs no surgery, 0.82 (per year over 70)). Co-morbidity, deprivation, symptomatic presentation, later stage at diagnosis and low grade are also associated with increased probability of non-surgical treatment.
CONCLUSION: Contrary to current NICE guidance in England, age appears to be an important factor in the decision to treat operable ER+ breast cancer non-surgically. Further research is needed to assess the role of other age-related factors on treatment choice, and the effect that current practice has on survival and mortality from breast cancer for older women.
Keywords: Breast cancer | elderly | surgery | comorbidity | retrospective study
قیمت: 1000 تومان