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1.
Clin Transl Oncol ; 21(12): 1746-1753, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31385227

RESUMO

INTRODUCTION: An increase in the number of cancer cases is expected in the near future. Breast cancer (BC) mortality rates increase with age even when adjusted for other variables. Here we analyzed BC disease-free survival (BCDFS) and BC specific survival (BCSS) in the El Alamo III BC registry of GEICAM Spanish Breast Cancer Group. MATERIALS AND METHODS: El Alamo III is a retrospective registry of BC patients diagnosed between 1998 and 2001. Patients with stage I-III invasive BC of age groups 55-64 years (y), 70-74 years and ≥ 75 years were included. Patients and tumors characteristics, treatments and recurrences and deaths were analyzed. RESULTS: 4343 patients were included within the following age intervals: 2288 (55-64 years), 960 (70-74 years), and 1095 (≥ 75 years). Older patients (≥ 70 years) were diagnosed with more advanced tumors (stage III) than younger patients (21.5% versus 13.4%, p < 0.0001). Mastectomies were performed more on older patients and they received less chemotherapy than younger patients (66.6% versus 43.1%, p < 0.00001 and 30.8% versus 71.6%, p < 0.0001, respectively). With a median follow-up of 5.9 years, 17.7% patients had BCDFS events in the younger group and 19.8% in the older group (p < 0.0001). A decrease in BCSS was also observed in older patients, either when analyzing patients ≥ 70y (p < 0.0001) and when differentiating by the two older groups (p < 0.0001). CONCLUSIONS: Our study suggests that older BC patients have worse outcomes what can be a consequence of receiving inadequate adjuvant treatments. Specific trials for these patients are warranted to allow us to treat them with the same scientific rigor than younger patients.


Assuntos
Neoplasias da Mama/mortalidade , Sistema de Registros/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias da Mama/química , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Sobreviventes de Câncer , Causas de Morte , Quimioterapia Adjuvante/estatística & dados numéricos , Intervalo Livre de Doença , Feminino , Humanos , Mastectomia/estatística & dados numéricos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Espanha/epidemiologia , Análise de Sobrevida
2.
Clin. transl. oncol. (Print) ; 20(9): 01117-1126, sept. 2018. tab, mapas, graf
Artigo em Inglês | IBECS | ID: ibc-173696

RESUMO

Population aging represents a worldwide challenge. In Ibero-America (Spain, Portugal, and the American countries in which the Spanish or Portuguese language are spoken), the number of older adults is growing, leading to an increase in aging-related diseases such as cancer. Older adults already account for half of all cancer cases in Ibero-America, and this proportion will continue to increase. Furthermore, Ibero-American healthcare systems are not adequately prepared to provide care for older adults with cancer, mainly due to a lack of resources and generalized paucity of geriatric training for healthcare providers. Across the region, several clinical initiatives, educational activities and research collaborations have been established to set the foundations of Ibero-American geriatric oncology and to increase the geriatric knowledge among healthcare providers. This article provides an overview of the current landscape of geriatric oncology in Ibero-America, highlighting its critical challenges, opportunities for improvement and collaboration, and future directions


No disponible


Assuntos
Humanos , Idoso , Neoplasias/epidemiologia , Serviços de Saúde para Idosos/estatística & dados numéricos , Serviço Hospitalar de Oncologia/estatística & dados numéricos , América Latina/epidemiologia , Portugal/epidemiologia , Espanha/epidemiologia
3.
Clin. transl. oncol. (Print) ; 20(8): 1087-1092, ago. 2018. mapas, graf
Artigo em Inglês | IBECS | ID: ibc-173693

RESUMO

Introduction: Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. Objectives: The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. Methods: A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. Results: Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. Conclusions: From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived


No disponible


Assuntos
Humanos , Oncologia/tendências , Geriatria/tendências , Avaliação Geriátrica/métodos , Espanha , Equipe de Assistência ao Paciente/tendências , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos
4.
Clin Transl Oncol ; 20(9): 1117-1126, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29435944

RESUMO

Population aging represents a worldwide challenge. In Ibero-America (Spain, Portugal, and the American countries in which the Spanish or Portuguese language are spoken), the number of older adults is growing, leading to an increase in aging-related diseases such as cancer. Older adults already account for half of all cancer cases in Ibero-America, and this proportion will continue to increase. Furthermore, Ibero-American healthcare systems are not adequately prepared to provide care for older adults with cancer, mainly due to a lack of resources and generalized paucity of geriatric training for healthcare providers. Across the region, several clinical initiatives, educational activities and research collaborations have been established to set the foundations of Ibero-American geriatric oncology and to increase the geriatric knowledge among healthcare providers. This article provides an overview of the current landscape of geriatric oncology in Ibero-America, highlighting its critical challenges, opportunities for improvement and collaboration, and future directions.


Assuntos
Envelhecimento , Geriatria , Neoplasias/terapia , Atenção à Saúde , Humanos , Neoplasias/epidemiologia , Portugal/epidemiologia , Espanha/epidemiologia
5.
Clin Transl Oncol ; 20(8): 1087-1092, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29327240

RESUMO

INTRODUCTION: Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. OBJECTIVES: The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. METHODS: A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. RESULTS: Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. CONCLUSIONS: From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.


Assuntos
Atenção à Saúde/normas , Avaliação Geriátrica , Geriatria/normas , Oncologia/normas , Neoplasias/terapia , Oncologistas/normas , Equipe de Assistência ao Paciente/normas , Idoso , Atenção à Saúde/organização & administração , Humanos , Espanha , Inquéritos e Questionários
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