Cancer-Specific Survival in Octogenarian Breast Cancer Patients: A Competing Risk Analysis of Prognostic Factors.
7 affiliations
- 1Department of Radiation Oncology, University of Health Sciences Turkey, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey.
- 2Department of Medical Oncology, University of Health Sciences Turkey, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey.
- 3Department of Nuclear Medicine, University of Health Sciences Turkey, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey.
- 4Department of General Surgery, University of Health Sciences Turkey, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey.
- 5Department of General Surgery, School of Medicine, Bahçeşehir University, 34734 Istanbul, Turkey.
- 6Department of Pathology, University of Health Sciences Turkey, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey.
- 7Department of Radiology, University of Health Sciences Turkey, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey.
Abstract
Background
This study evaluated long-term survival outcomes in breast cancer patients aged ≥80 years, focusing on how prognostic factors change when competing mortality risks are considered.Methods
We retrospectively analyzed 106 octogenarian breast cancer patients treated between 2013 and 2023. Endocrine therapy was evaluated as a treatment-related prognostic factor. Treatment-related prognostic factors were evaluated using multivariable Cox proportional hazards and Fine-Gray competing-risks models.Results
The median age was 82 years, and the median follow-up time was 27.5 months (range, 6-99 months). In the multivariable Cox proportional hazards, biopsy compared with surgery (HR, 0.56; p = 0.037), presence of endocrine therapy (HR, 0.38; p = 0.003), and CCI ≥ 8 (HR, 9.96; p < 0.001) were independently associated with OS. In the Fine-Gray model, the associations of surgical procedure (p = 0.120) and endocrine therapy (p = 0.081) with breast cancer-specific mortality were no longer statistically significant. CCI ≥ 8 remained significantly associated with breast cancer-specific mortality (sHR, 3.76; 95% CI, 1.52-9.31; p = 0.004).Conclusions
In octogenarian breast cancer patients, surgery and endocrine therapy were associated with improved OS, but their associations with breast cancer-specific mortality were attenuated after accounting for competing risks. High CCI emerged as the most robust prognostic factor. These findings support incorporating comorbidity burden and competing-risks assessment into individualized treatment decisions in this population.
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BibTeX
@article{mermut2026cancerspecific,
title = {{Cancer-Specific Survival in Octogenarian Breast Cancer Patients: A Competing Risk Analysis of Prognostic Factors.}},
author = {Özlem Mermut and Berrin Yalçın and Rıza Umar Gürsu and Esra Arslan and Bülent Akçe and Didem Can Trabulus and Semiha Battal Havare and Serap Karabıyık},
journal = {Current oncology (Toronto, Ont.)},
year = {2026},
month = oct,
doi = {10.3390/curroncol33100636},
url = {https://europepmc.org/article/MED/42930203},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cancer-Specific Survival in Octogenarian Breast Cancer Patients: A Competing Risk Analysis of Prognostic Factors.
AU - Özlem Mermut
AU - Berrin Yalçın
AU - Rıza Umar Gürsu
AU - Esra Arslan
AU - Bülent Akçe
AU - Didem Can Trabulus
AU - Semiha Battal Havare
AU - Serap Karabıyık
PY - 2026
DA - 2026/10/20
JO - Current oncology (Toronto, Ont.)
DO - 10.3390/curroncol33100636
UR - https://europepmc.org/article/MED/42930203
AB - Background This study evaluated long-term survival outcomes in breast cancer patients aged ≥80 years, focusing on how prognostic factors change when competing mortality risks are considered.Methods We retrospectively analyzed 106 octogenarian breast cancer patients treated between 2013 and 2023. Endocrine therapy was evaluated as a treatment-related prognostic factor. Treatment-related prognostic factors were evaluated using multivariable Cox proportional hazards and Fine-Gray competing-risks models.Results The median age was 82 years, and the median follow-up time was 27.5 months (range, 6-99 months). In the multivariable Cox proportional hazards, biopsy compared with surgery (HR, 0.56; p = 0.037), presence of endocrine therapy (HR, 0.38; p = 0.003), and CCI ≥ 8 (HR, 9.96; p < 0.001) were independently associated with OS. In the Fine-Gray model, the associations of surgical procedure (p = 0.120) and endocrine therapy (p = 0.081) with breast cancer-specific mortality were no longer statistically significant. CCI ≥ 8 remained significantly associated with breast cancer-specific mortality (sHR, 3.76; 95% CI, 1.52-9.31; p = 0.004).Conclusions In octogenarian breast cancer patients, surgery and endocrine therapy were associated with improved OS, but their associations with breast cancer-specific mortality were attenuated after accounting for competing risks. High CCI emerged as the most robust prognostic factor. These findings support incorporating comorbidity burden and competing-risks assessment into individualized treatment decisions in this population.
SN - 1198-0052
SN - 1718-7729
ER -