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01-05-2014 | Epidemiology

Impact of comorbidity on outcome of older breast cancer patients: a FOCUS cohort study

Authors: Mandy Kiderlen, Nienke A. de Glas, Esther Bastiaannet, Willemien van de Water, Anton J. M. de Craen, Onno R. Guicherit, Jos W. S. Merkus, Martine Extermann, Cornelis J. H. van de Velde, Gerrit-Jan Liefers

Published in: Breast Cancer Research and Treatment | Issue 1/2014

Abstract

Older breast cancer patients often suffer from comorbid diseases, which may influence life expectancy. The aim of this study was to assess the impact of specific comorbidities on overall survival and distant recurrence free period (DRFP) of older breast cancer patients. Patients were included from the population-based FOCUS cohort which contains 3,672 breast cancer patients aged 65 years or older. The impact of comorbidity on overall survival and DRFP was analyzed using multivariable Cox proportional hazard models and Poisson regression models. Median follow-up time was 6.8 years (range 0–14.0). Irrespective of age; the number of comorbid diseases was significantly associated with worse overall survival [hazard ratio (HR) per increasing number of comorbid diseases: 1.20, 95 % confidence interval (CI) 1.13–1.27 and HR 1.09, 95 % CI 1.05–1.13 for age <75 and age ≥75, respectively]. Median follow-up time for DRFP was 5.7 years (range 0–14.0). An increasing number of comorbid diseases was associated with a decreasing risk of metastases among patients aged ≥75 (HR 0.94, 95 % CI 0.87–1.02), whereas an increasing risk was shown for patients aged <75 (HR 1.09, 95 % CI 1.01–1.19). This study shows that in older breast cancer, patients overall survival and DRFP are influenced by comorbidity. This reiterates that patient outcome is not only influenced by breast cancer, and non-cancer-related factors should be taken into account.

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Title: Impact of comorbidity on outcome of older breast cancer patients: a FOCUS cohort study
Authors: Mandy Kiderlen
Nienke A. de Glas
Esther Bastiaannet
Willemien van de Water
Anton J. M. de Craen
Onno R. Guicherit
Jos W. S. Merkus
Martine Extermann
Cornelis J. H. van de Velde
Gerrit-Jan Liefers
Publication date: 01-05-2014
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 1/2014
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-014-2917-7

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