Development and validation of the PORTRET tool to predict recurrence, overall survival, and other-cause mortality in older patients with breast cancer in the Netherlands: a population-based study

Plas-Krijgsman, Willeke G van der; Giardiello, Daniele; Putter, Hein; Bastiaannet, E.; Stiggelbout, Anne M.; Mooijaart, Simon P.; Kroep, Judith R.; Portielje, Johanneke E.A.; Liefers, Gerrit‐Jan; Glas, Nienke A. de

doi:10.1016/s2666-7568(21)00229-4

Cited by 20 publications

(16 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings are similar to those of the present study, which confirmed a higher percentage of non-cancer deaths in the group with no axillary treatment. With the aim of predicting 5-year survival and recurrence, and to subsequently optimize treatment in older patients (aged at least 65 years), the PORTRET tool was developed in 2021 47 . Age, tumour characteristics, co-morbidities according to the ICD-10 classification, and geriatric predictors, such as walking difficulties, dementia or cognitive impairment, polypharmacy, and sensory deficits, were included in this tool.…”

Section: Discussionmentioning

confidence: 99%

De-escalation of axillary treatment in the event of a positive sentinel lymph node biopsy in cT1–2 N0 breast cancer treated with mastectomy: nationwide registry study (BOOG 2013-07)

de Wild,

van Roozendaal,

de Wilt

et al. 2024

British Journal of Surgery

View full text Add to dashboard Cite

Background Trials have demonstrated the safety of omitting completion axillary lymph node dissection in patients with cT1–2 N0 breast cancer operated with breast-conserving surgery who have limited metastatic burden in the sentinel lymph node. The aim of this registry study was to provide insight into the oncological safety of omitting completion axillary treatment in patients operated with mastectomy who have limited-volume sentinel lymph node metastasis. Methods Women diagnosed in 2013–2014 with unilateral cT1–2 N0 breast cancer treated with mastectomy, with one to three sentinel lymph node metastases (pN1mi–pN1a), were identified from the Netherlands Cancer Registry, and classified by axillary treatment: no completion axillary treatment, completion axillary lymph node dissection, regional radiotherapy, or completion axillary lymph node dissection followed by regional radiotherapy. The primary endpoint was 5-year regional recurrence rate. Secondary endpoints included recurrence-free interval and overall survival, among others. Results In total, 1090 patients were included (no completion axillary treatment, 219 (20.1%); completion axillary lymph node dissection, 437 (40.1%); regional radiotherapy, 327 (30.0%); completion axillary lymph node dissection and regional radiotherapy, 107 (9.8%)). Patients in the group without completion axillary treatment had more favourable tumour characteristics and were older. The overall 5-year regional recurrence rate was 1.3%, and did not differ significantly between the groups. The recurrence-free interval was also comparable among groups. The group of patients who did not undergo completion axillary treatment had statistically significantly worse 5-year overall survival, owing to a higher percentage of non-cancer deaths. Conclusion In this registry study of patients with cT1–2 N0 breast cancer treated with mastectomy, with low-volume sentinel lymph node metastasis, the 5-year regional recurrence rate was low and comparable between patients with and without completion axillary treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

De-escalation of axillary treatment in the event of a positive sentinel lymph node biopsy in cT1–2 N0 breast cancer treated with mastectomy: nationwide registry study (BOOG 2013-07)

de Wild,

van Roozendaal,

de Wilt

et al. 2024

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…More recently, it was shown that individual risk estimation for older patients could be improved by incorporating comorbidity and functional parameters, considering the individual competing risk of death [38]. Given the complexity of tamoxifen metabolism, in order to improve the prediction of tamoxifen efficacy and safety, large studies with complex analysis would be required [39].…”

Section: Discussionmentioning

confidence: 99%

Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer

Souwer

Sanchez-Spitman

Moes

et al. 2023

Breast Cancer Res Treat

View full text Add to dashboard Cite

Background We aimed to study the pharmacokinetics and -dynamics of tamoxifen in older women with non-metastatic breast cancer. Methods Data for this analysis were derived from the CYPTAM study (NTR1509) database. Patients were stratified by age (age groups < 65 and 65 and older). Steady-state trough concentrations were measured of tamoxifen, N-desmethyltamoxifen, 4-hydroxy-tamoxifen, and endoxifen. CYP2D6 and CYP3A4 phenotypes were assessed for all patients by genotyping. Multiple linear regression models were used to analyze tamoxifen and endoxifen variability. Outcome data included recurrence-free survival at time of tamoxifen discontinuation (RFSt) and overall survival (OS). Results 668 patients were included, 141 (21%) were 65 and older. Demographics and treatment duration were similar across age groups. Older patients had significantly higher concentrations of tamoxifen 129.4 ng/ml (SD 53.7) versus 112.2 ng/ml (SD 42.0) and endoxifen 12.1 ng/ml (SD 6.6) versus 10.7 ng/ml (SD 5.7, p all < 0.05), independently of CYP2D6 and CYP3A4 gene polymorphisms. Age independently explained 5% of the variability of tamoxifen (b = 0.95, p < 0.001, R2 = 0.051) and 0.1% of the variability in endoxifen concentrations (b = 0.45, p = 0.12, R2 = 0.007). Older patients had worse RFSt (5.8 versus 7.3 years, p = 0.01) and worse OS (7.8 years versus 8.7 years, p = 0.01). This was not related to differences in endoxifen concentration (HR 1.0, 95% CI 0.96–1.04, p = 0.84) or CYP polymorphisms. Conclusion Serum concentrations of tamoxifen and its demethylated metabolites are higher in older patients, independent of CYP2D6 or CYP3A4 gene polymorphisms. A higher bioavailability of tamoxifen in older patients may explain the observed differences. However, clinical relevance of these findings is limited and should not lead to a different tamoxifen dose in older patients.

show abstract

“…We examined the connection between married individuals’ moods and potential prognoses. Age-specific information was not included in this study; instead, a subgroup of participants was examined [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Factors Related to Depressive Symptoms Among Married Individuals

Krishnan,

Batra,

Batra

et al. 2023

Cureus

View full text Add to dashboard Cite

Background There are multiple studies that indicate that the psychological well-being of a couple and their life satisfaction depend on the family and society. Various factors such as family, family values, marriage style, married life, and education have a great impact on people's lives both directly and indirectly. It is important to understand the effects of these factors on married individuals' lives that lead to depression so that appropriate measures can be taken for its prevention. Objectives This research aims to find the relationship of depressive symptoms among married individuals with various factors such as their marriage style, education, and having children. Materials and methods The study included 433 married individuals from Istanbul who met the criteria for depression. The early identification and prediction of depression in married individuals have been demonstrated to benefit significantly from machine learning techniques. In this study, we used decision tree (DT) and random forest (RF) predictive modeling techniques to create a model to predict the occurrence of depression among married individuals. Results The accuracy of the DT approach was found to be 80%, and the RF approach was 60%. Our results showed that as compared to conventional statistical methods, machine learning models performed better for classifying couples. Conclusion Future support systems that employ a range of data sources to identify individuals who are extremely susceptible to developing depression among married people may be developed using these effective models.

show abstract

Development and validation of the PORTRET tool to predict recurrence, overall survival, and other-cause mortality in older patients with breast cancer in the Netherlands: a population-based study

Cited by 20 publications

References 38 publications

De-escalation of axillary treatment in the event of a positive sentinel lymph node biopsy in cT1–2 N0 breast cancer treated with mastectomy: nationwide registry study (BOOG 2013-07)

De-escalation of axillary treatment in the event of a positive sentinel lymph node biopsy in cT1–2 N0 breast cancer treated with mastectomy: nationwide registry study (BOOG 2013-07)

Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer

Prevalence of Factors Related to Depressive Symptoms Among Married Individuals

Contact Info

Product

Resources

About