Скачать или смотреть Catching cancers when they are small still makes a difference to survival

Read the full open access research:
http://www.bmj.com/content/351/bmj.h4901

Catching cancers when they are small still makes a difference
to survival, even in the current era of more effective therapies,
suggests a study of breast cancer patients in The BMJ this
week.

The research team, based in the Netherlands, say that
traditional factors such as tumour size and number of positive
lymph nodes “still have a significant and major influence on
overall mortality independent of age and tumour biology.”
Breast cancer survival rates have increased significantly all
over the world in the past decades, mainly due to earlier
diagnosis and better treatment options. As such, it has been
suggested that traditional prognostic factors, such as tumour
size and number of positive lymph nodes, may no longer
predict survival. And if these factors do affect survival, the size
of this effect is unknown.

So researchers set out to estimate whether these factors still
influence survival by comparing overall survival of 173,797
female breast cancer patients from two time frames (1999-2005
and 2006-12) using data from the Netherlands Cancer Registry.
Factors such as date and age at breast cancer diagnosis,
tumour characteristics, and treatments were taken into account.
Compared with 1999-2005, tumours diagnosed in 2006-12
were smaller, more often lymph node negative, and more often
low grade. Patients diagnosed in 2006-12 more often had
breast conserving therapy and uptake of hormonal therapy,
chemotherapy, and drug therapy was increased.

Compared with 1999-2005, relative survival rates and overall
survival rates were higher for the 2006-12 cohort for all tumour
and nodal stages, especially in women aged over 75 years.
Overall relative survival of patients improved from 91% to 96%
at five years’ follow up.

The results show that both tumour stage and lymph node status
had a significant influence on overall survival in both cohorts.
The researchers stress that this is an observational study so no
definitive conclusions can be drawn about cause and effect.
Nevertheless, they say that tumour size and nodal status “still
have a significant and major influence on overall mortality
independent of age and tumour biology in the current era of
more conservative surgery and newer systemic therapies.