Predicting postoperative complications and their impact on quality of life and functional status in older patients with breast cancer.

BACKGROUND: The percentage of older patients undergoing surgery for early-stage breast cancer has decreased over the past decade. This study aimed to develop a prediction model for postoperative complications to better inform patients about the benefits and risks of surgery, and to investigate the association between complications and functional status and quality of life (QoL). METHODS: Women aged at least 70 years who underwent surgery for Tis-3 N0 breast cancer were included between 2013 and 2018. The primary outcome was any postoperative complication within 30 days after surgery. Secondary outcomes included functional status and QoL during the first year after surgery, as assessed by the Groningen Activity Restriction Scale and the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-BR23 questionnaires. A prediction model was developed using multivariable logistic regression and validated externally using data from the British Bridging the Age Gap Study. Linear mixed models were used to assess QoL and functional status over time. RESULTS: The development and validation cohorts included 547 and 2727 women respectively. The prediction model consisted of five predictors (age, polypharmacy, BMI, and type of breast and axillary surgery) and performed well in internal (area under curve (AUC) 0.76, 95 per cent c.i. 0.72 to 0.80) and external (AUC 0.70, 0.68 to 0.72) validations. Functional status and QoL were not affected by postoperative complication after adjustment for confounders. CONCLUSION: This validated prediction model can be used to counsel older patients with breast cancer about the postoperative phase. Postoperative complications did not affect functional status nor QoL within the first year after surgery even after adjustment for predefined confounders.

Surgery remains the standard of care for the majority of older patients with breast cancer. The percentage of older patients with breast cancer receiving surgery is decreasing. The reason for this decline is unknown, but it might be due to fear of complications. To better inform patients about the benefits and risks of surgery, the aim of this study was to develop a prediction model for complications after surgery. Another important aspect, especially for older adults with breast cancer, is quality of life, functional capacity, and ability to carry out daily tasks (functional status) after therapy. This study showed that quality of life and functional status did not decline after breast surgery, irrespective of the occurrence of postoperative complications.

Litho- and biostratigraphic data of lower-middle Miocene sections in the Transylvanian basin and SE Carpathian Foredeep (Romania).

Litho- and biostratigraphic data are provided of 5 stratigraphic sections in Romania covering the "Badenian" marine flooding that occurred in the Central Paratethys during the middle Miocene (Langhian). The dataset includes stratigraphic logs and descriptions of the profiles, and biostratigraphic analyses on calcareous nannofossils and foraminifera. In addition, characteristic stratigraphic features and representative fossils, including tiny Streptochilus foraminifera in the Campinita section in the SE Carpathian Foredeep, are presented in photographs. The data show that the flooding is characterized by the sudden abundance of Langhian calcareous nannofossils and foraminifera with a strong Mediterranean affinity.

Data on lithofacies, sedimentology and palaeontology of South Rifian Corridor sections (Morocco).

We provide lithological, sedimentological and micropalaeontological descriptions of 39 sections and boreholes crossing the upper Miocene deposits of the Rifian Corridor. These deposits represent the sedimentary remnants of the marine gateway that connected the Atlantic to the Mediterranean in the late Miocene. Results from these 39 sites were adopted to reconstruct the palaeogeographic evolution of the gateway presented in the associated research article (Capella et al., 2018) [1]. For each outcrop we present a synthesis of field observations, lithofacies, key sedimentological features, planktic and benthic assemblages.

Synchronizing rock clocks of Earth history.

Calibration of the geological time scale is achieved by independent radioisotopic and astronomical dating, but these techniques yield discrepancies of approximately 1.0% or more, limiting our ability to reconstruct Earth history. To overcome this fundamental setback, we compared astronomical and 40Ar/39Ar ages of tephras in marine deposits in Morocco to calibrate the age of Fish Canyon sanidine, the most widely used standard in 40Ar/39Ar geochronology. This calibration results in a more precise older age of 28.201 +/- 0.046 million years ago (Ma) and reduces the 40Ar/39Ar method's absolute uncertainty from approximately 2.5 to 0.25%. In addition, this calibration provides tight constraints for the astronomical tuning of pre-Neogene successions, resulting in a mutually consistent age of approximately 65.95 Ma for the Cretaceous/Tertiary boundary.