Age at diagnosis predicted survival outcome of female patients with breast cancer at a tertiary hospital in Yogyakarta, Indonesia

Evi Susanti Sinaga, Riris Andono Ahmad, Siddharudha Shivalli, Susanna Hilda Hutajulu, Evi Susanti Sinaga, Riris Andono Ahmad, Siddharudha Shivalli, Susanna Hilda Hutajulu

Abstract

Introduction: Breast cancer is the most common cancer in women in Indonesia. Patients' survival depends on various factors, namely patient-, tumor-, and treatment-related factors. Survival analysis on Indonesian patients has only been reported in a few studies. This study aimed to identify the factors that are associated with five-year overall survival (OS) among patients with breast cancer at a local tertiary hospital in Indonesia.

Methods: A retrospective cohort study was conducted at Dr Sardjito Hospital, Yogyakarta. Female patients diagnosed with breast cancer between January and December 2009 were studied. Socio-demographic and clinicopathological data were collected from the medical and pathological records. The five-year OS rate was assessed using Kaplan Meier method and prognostic factors were analyzed using Cox regression.

Results: A total of 213 eligible patients with breast cancer were recruited. The five-year OS probability of the breast cancer patient was 51.07%. The majority of the patients (151, 70.9%) presented an advanced stage at the time of diagnosis. In the bi-variable analysis, cases who were younger, of a lower educational status, at a more advanced stage, with a bigger tumor size, and a central tumor location showed a worse five-year OS compared to their counterparts (p = 0.005, 0.001, 0.004, 0.011 and 0.023, respectively). In the multivariable analysis, age was an independent predictor for the OS (HR = 3.73; 95% CI = 1.0-13.6, p = 0.046).

Conclusion: The five-year OS of breast cancer patients in the local tertiary hospital was 51.07%. The patients' age at diagnosis was the only significant prognostic factor for the patients' survival.

Keywords: Breast cancer; Indonesia; age; five-year overall survival.

Figures

Figure 1
Figure 1
Kaplan-Meier plot comparing five-year overall survival (OS) between patients with breast cancer aged ≥50 years and

References

    1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015 Mar 1;136(5):E359–86.
    1. WHO, International Agency for Research on Cancer . Latest world cancer statistics Global cancer burden rises to 14.1 million new cases in 2012: Marked increase in breast cancers must be addressed. Accessed on 1st Nov 2018.
    1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014 Jan-Feb;64(1):9–29.
    1. Wahidin M, Noviani R, Hermawan S, Andriani V, Ardian A, Djarir H. Population-based cancer registration in Indonesia. Asian Pac J Cancer Prev. 2012;13(4):1709–10.
    1. Departemen Kesehatan Republik Indonesia . Pedoman Teknis Pengendalian Kanker Payudara dan Kanker Leher Rahim, Jakarta. Departemen Kesehatan Republik Indonesia; 2010. p. 13. (INA)
    1. WHO Control of cancer of the cervix uteri. A WHO meeting. Bull World Health Organ. 1986;64(4):607–18.
    1. Brandt J, Garne JP, Tengrup I, Manjer J. Age at diagnosis in relation to survival following breast cancer: a cohort study. World J Surg Oncol. 2015:13:33.
    1. Aryandono T, Harijadi Soeripto. Breast cancer in young women: prognostic factors and clinicopathological features. Asian Pac J Cancer Prev. 2006 Jul-Sep;7(3):451–4.
    1. Aryandono T, Harijadi Soeripto. Survival from operable breast cancer: prognostic factors in Yogyakarta, Indonesia. Asian Pac J Cancer Prev. 2006 Jul-Sep;7(3):455–9.
    1. McPherson K, Steel CM, Dixon JM. ABC of breast diseases, breast cancer-epidemiology, risk factors, and genetics. BMJ. 2000 Sep 9;321(7261):624–8.
    1. Bahk J, Jang SM, Jung-Choi K. Increased breast cancer mortality only in the lower education group: age-period-cohort effect in breast cancer mortality by educational level in South Korea, 1983-2012. Int J Equity Health. 2017 Mar 31;16(1):56.
    1. Baquet CR, Commiskey P. Socioeconomic factors and breast carcinoma in multicultural women. Cancer. 2000 Mar 1;88(5 Suppl):1256–64.
    1. Fagerholm R, Faltinova M, Aaltonen K, Aittomaki K, Heikkila P, Halttunen-Nieminen M, et al. Family history influences the tumor characteristics and prognosis of breast cancers developing during postmenopausal hormone therapy. Fam Cancer. 2018 Jul;17(3):321–31.
    1. Martinez ME, Unkart JT, Tao L, Kroenke CH, Schwab R, Komenaka I, et al. Prognostic significance of marital status in breast cancer survival: A population-based study. PLoS One. 2017 May 5;12(5):e0175515.
    1. Gomez SL, Hurley S, Canchola AJ, Keegan TH, Cheng I, Murphy JD, et al. Effects of marital status and economic resources on survival after cancer: A population-based study. Cancer. 2016 May 15;122(10):1618–25.
    1. Schonberg MA, Marcantonio ER, Li D, Silliman RA, Ngo L, McCarthy EP. Breast cancer among the oldest old: tumor characteristics, treatment choices, and survival. J Clin Oncol. 2010 Apr 20;28(12):2038–45.
    1. Karimi A, Delpisheh A, Sayehmiri K, Saboori H, Rahimi E. Predictive factors of survival time of breast cancer in kurdistan province of Iran between 2006-2014: a cox regression approach. Asian Pac J Cancer Prev. 2014;15(19):8483–8.
    1. Rosenberg J, Chia YL, Plevritis S. The effect of age, race, tumor size, tumor grade, and disease stage on invasive ductal breast cancer survival in the US SEER database. Breast Cancer Res Treat. 2005 Jan;89(1):47–54.
    1. Yancik R, Wesley MN, Ries LA, Havlik RJ, Edwards BK, Yates JW. Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA. 2001 Feb 21;285(7):885–92.
    1. Gaitanidis A, Alevizakos M, Tsalikidis C, Tsaroucha A, Simopoulos C, Pitiakoudis M. Refusal of cancer-directed surgery by breast cancer patients: risk factors and survival outcomes. Clin Breast Cancer. 2018 Aug;18(4):e469–76.
    1. Maishman T, Cutress RI, Hernandez A, Gerty S, Copson ER, Durcan L, et al. Local recurrence and breast oncological surgery in young women with breast cancer: The POSH Observational Cohort Study. Ann Surg. 2017 Jul;266(1):165–72.
    1. Widodo I, Dwianingsih EK, Anwar SL, Fx Ediati T, Utoro T, Aryandono T, et al. Prognostic value of clinicopathological factors for indonesian breast carcinomas of different molecular subtypes. Asian Pac J Cancer Prev. 2017;18(5):1251–6.
    1. Arif Harahap W, Ramadhan, Khambri D, Haryono S, Dana Nindrea R. Outcomes of trastuzumab therapy for 6 and 12 months in indonesian national health insurance system clients with operable HER2-positive breast cancer. Asian Pac J Cancer Prev. 2017 Apr 1;18(4):1151–6.
    1. Lang TA, Secic M. How to report statistics in medicine: annotated guidelines for authors, editors and reviewers. 2nd ed. Philadelphia: American College of Physicians; 2006.
    1. Mariotto AB, Noone AM, Howlader N, Cho H, Keel GE, Garshell J, et al. Cancer survival: an overview of measures, uses and interpretation. J Natl Cancer Inst Monogr. 2014 Nov;2014(49):145–86.
    1. Bewick V, Cheek L, Ball J. Statistics review 12: survival analysis. Crit Care. 2004 Oct;8(5):389–94.
    1. Goel MK, Khanna P, Kishore J. Understanding survival analysis: Kaplan-Meier estimate. Int J Ayurveda Res. 2010 Oct-Dec;1(4):274–8.
    1. Abdullah NA, Wan Mahiyuddin WR, Muhammad NA, Ali ZM, Ibrahim L, Ibrahim Tamim NS, et al. Survival rate of breast cancer patients in Malaysia: a population-based study. Asian Pac J Cancer Prev. 2013;14(8):4591–4.
    1. Sankaranarayanan R, Swaminathan R, Brenner H, Chen K, Chia KS, Chen JG, et al. Cancer survival in Africa, Asia, and Central America: a population-based study. Lancet Oncol. 2010 Feb;11(2):165–73.
    1. Coleman MP, Quaresma M, Berrino F, Lutz JM, De Angelis R, Capocaccia R, et al. Cancer survival in five continents: a worldwide population-based study (CONCORD) Lancet Oncol. 2008 Aug;9(8):730–56.
    1. Autier P, Boniol M, Hery C, Masuyer E, Ferlay J. Cancer survival statistics should be viewed with caution. Lancet Oncol. 2007 Dec;8(12):1050–2.
    1. Shulman LN, Willett W, Sievers A, Knaul FM. Breast cancer in developing countries: opportunities for improved survival. J Oncol. 2010;2010:595167.
    1. Burstein H, Harris J, Morrow M. Malignant Tumor of The Breast. In: DeVita VT, Lawrence TS, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology 2008. USA: Lippincott William & Wilkins; pp. 1617–9.
    1. Musolino A, Bella MA, Bortesi B, Michiara M, Naldi N, Zanelli P, et al. BRCA mutations, molecular markers, and clinical variables in early-onset breast cancer: a population-based study. Breast. 2007 Jun;16(3):280–92.
    1. Roder D, Webster F, Zorbas H, Sinclair S. Breast screening and breast cancer survival in Aboriginal and Torres Strait Islander women of Australia. Asian Pac J Cancer Prev. 2012;13(1):147–55.
    1. Sant M, Capocaccia R, Verdecchia A, Esteve J, Gatta G, Micheli A, et al. Survival of women with breast cancer in Europe: variation with age, year of diagnosis and country The EUROCARE Working Group. Int J Cancer. 1998 Aug 31;77(5):679–83.

Source: PubMed

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