Preprint findings can help oncologists counsel older patients about their treatment options. OncTwitter chemotherapy
decreases overall survival in otherwise healthy women who are 65- to 79-years-old, but not in women 80 years or older.This study is the first to correlate chemotherapy refusal and overall survival in older women with no comorbidities at high risk for recurrence who would otherwise be considered candidates for adjuvant chemotherapy.
The findings can help oncologists counsel older patients with breast cancer about the benefits they can expect from chemotherapy. Investigators reviewed 6827 women with ER-positive, HER2-negative breast cancer at high genomic risk for recurrence using the National Cancer Database from 2010 to 2017.
The study excluded patients with a Charlson Comorbidity Index of 1 or higher and those with stage 3/4 disease. Women who refused were slightly older , received radiation less frequently , and were diagnosed more recently. Chemotherapy refusal was associated with a significant decrease in 5-year overall survival for women aged 65-74 compared with those who opted for chemotherapy and 75-79 . However, refusal was not associated with a significant decrease in 5-year overall survival for women aged 80 or older .
Overall, the risk of death increased with chemotherapy refusal ; but again, when stratified by age, those aged 80 or older did not face a significantly greater risk of death (HR, 1.10; 95% CI, 0.80 - 1.51;
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