Evidence map›Paper›PMID 33735487›Full record

ArticleCancer2021

Impact of adjuvant endocrine therapy in older patients with comorbidities and estrogen receptor-positive, node-negative breast cancer-A National Cancer Database analysis.

Nina Tamirisa, Heather Lin, Yu Shen, Simona F Shaitelman, Meghan S Karuturi, Sharon H Giordano, Gildy V Babiera, Isabelle Bedrosian

Erratum issuedOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 41% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Nina TamirisaDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.ORCID 0000-0002-0451-0759
Heather LinDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.ORCID 0000-0002-1779-7007
Yu ShenDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Simona F ShaitelmanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Meghan S KaruturiDepartment of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.ORCID 0000-0001-8795-3901
Sharon H GiordanoDepartment of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Gildy V BabieraMD Anderson Physician Network, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Isabelle BedrosianDepartment of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.ORCID 0000-0002-8775-8361
The University of Texas MD Anderson Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
Clonally Expanded Mutations Identify Cancer Precursors in Chronic InflammationR01CA160674 · NCI · UNIVERSITY OF WASHINGTON · PI BRENTNALL, TERESA A, LOEB, LAWRENCE A · 2012 to 2016
$2.8M
Cancer Prevention and Research Institute of Texas RP160674NCI NIH HHS P30 CA016672Susan G. Komen Foundation SAC150061
6 · The paper itself

Abstract

backgroundData are lacking about the benefit of adjuvant endocrine therapy (ET) in older patients with multiple comorbidities. The authors sought to determine the effect of ET on the survival of older patients who had multiple comorbidities and estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, pathologic node-negative (pN0) breast cancer.

methodsWomen aged ≥70 years in the National Cancer Database (2010-2014) with Charlson/Deyo comorbidity scores of 2 or 3 who had pathologic tumor (pT1)-pT3/pN0, ER-positive/HER2-negative breast cancer were divided into 2 cohorts: adjuvant ET and no ET. Propensity scores were used to match patients based on age, comorbidity score, facility type, pT classification, chemotherapy, surgery, and radiation therapy. A Cox proportional hazards model was used to estimate the effect of ET on overall survival (OS).

resultsIn the nonmatched cohort (n = 3716), 72.8% of patients received ET (n = 2705), and 27.2% did not (n = 1011). The patients who received ET were younger (mean age, 76 vs 79 years; P < .001) and had higher rates of breast conservation compared with those who did not receive ET (lumpectomy plus radiation: 43.4% vs 23.8%, respectively; P < .001). In the matched cohort (n = 1972), the median OS was higher in the ET group (79.2 vs 67.7 months; P < .0001). In the adjusted analysis, ET was associated with improved survival (hazard ratio, 0.70; 95% CI, 0.59-0.83).

conclusionsIn older patients who have pN0, ER-positive/HER2-negative breast cancer with comorbidities, adjuvant ET was associated with improved OS, which may have been overestimated given the confounders inherent in observational studies. To optimize outcomes in these patients, current standard recommendations should be considered stage-for-stage based on life expectancy and the level of tolerance to treatment.

Indexed as

Breast NeoplasmsReceptors, EstrogenAgedChemotherapy, AdjuvantCombined Modality TherapyComorbidityErb-b2 Receptor Tyrosine KinasesFemaleHumansMastectomy, SegmentalErb-b2 Receptor Tyrosine KinasesReceptors, Estrogenadjuvantbreast cancerendocrine therapyolder

Identifiers

PMID33735487
PMCPMC8195825
OpenAlexW3138915412

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.