被撤回的出版物: Impact of Cooperative Trial and Sociodemographic Variation on Adjuvant Radiation Therapy Usage in Elderly Women (≥70 Years) with Stage I, Estrogen Receptor-Positive Breast Cancer: Analysis of the National Cancer Data Base(Retracted article. See vol.224, pg.1008, 2017)

[摘要] BACKGROUND: TheCancer and LeukemiaGroup B (CALGB) 9343 trial demonstrated that adjuvant radiation therapy (RT) can be omitted inwomen aged 70 years or older, with small, estrogen receptor (ER)+ breast cancer. We postulated that RT usage after CALGB's publication should have decreased over time. STUDY DESIGN: We evaluated a cohort of 205,860 women aged 70 years or older, with stage I, ER+/progesterone receptor (PR)+ breast cancer with lumpectomy, diagnosed between 1998 and 2012, in the National Cancer Data Base. Clinicopathologic and sociodemographic variables were compared between preCALGB and post-CALGB publication (circa 2004). Univariate and multivariate analysis were used. RESULTS: Radiation therapy usage decreased by only 2.95% after CALGB publication (68.71% vs 65.76%; p < 0.0001). Almost one-third of women with short life expectancy (>= 85 years) received RT in the post-CALGB group. Significant predictors (p < 0.01) of lowest RT use include advanced age, increased great circle distance, academic research program, East South Central region, rural population < 2,500 not adjacent to a metropolitan area, low income level, high comorbidity index, small tumor, well-differentiated histology, residual tumor, and lack of receipt of anti-hormonal therapy. CONCLUSIONS: The CALGB trial had a minimal impact on the rate of adjuvant RT use among elderly women with small, hormone positive breast cancers. Significant variation in RT usage exists across sociodemographic strata. (J Am Coll Surg 2016;222:667-678. (C) 2016 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.)

[发布日期] 2016-04-01

[效力级别]  Proceedings Paper