Evidence map›Paper›PMID 37706222›Full record

ArticleCancer medicine2023

Association between adjuvant radiation treatment and breast cancer-specific mortality among older women with comorbidity burden: A comparative effectiveness analysis of SEER-MHOS.

Eunkyung Lee, Robert B Hines, Jianbin Zhu, Michael J Rovito, Kavita V Dharmarajan, Madhu Mazumdar

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Eunkyung LeeDepartment of Health Sciences, University of Central Florida College of Health Professions and Sciences, Florida, Orlando, USA.ORCID 0000-0003-1732-5998
Robert B HinesDepartment of Population Health Sciences, University of Central Florida College of Medicine, Florida, Orlando, USA.ORCID 0000-0001-7139-3102
Jianbin ZhuDepartment of Statistics and Data Science, University of Central Florida College of Sciences, Florida, Orlando, USA.
Michael J RovitoDepartment of Health Sciences, University of Central Florida College of Health Professions and Sciences, Florida, Orlando, USA.ORCID 0000-0001-8086-3460
Kavita V DharmarajanDepartment of Radiation Oncology, Department of Geriatrics Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Madhu MazumdarInstitute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
University of Central Florida · USIcahn School of Medicine at Mount Sinai · US

Funding

Improving Outcomes for Older Adults Undergoing Palliative Radiation TreatmentK76AG068516 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI DHARMARAJAN, KAVITA VYAS · 2021 to 2025
$1.2M
NIA NIH HHS K76 AG068516
6 · The paper itself

Abstract

backgroundThe National Comprehensive Cancer Network suggested that older women with low-risk breast cancer (LRBC; i.e., early-stage, node-negative, and estrogen receptor-positive) could omit adjuvant radiation treatment (RT) after breast-conserving surgery (BCS) if they were treated with hormone therapy. However, the association between RT omission and breast cancer-specific mortality among older women with comorbidity is not fully known.

methods1105 older women (≥65 years) with LRBC in 1998-2012 were queried from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data resource and were followed up through July 2018. Latent class analysis was performed to identify comorbidity burden classes. A propensity score-based inverse probability of treatment weighting (IPTW) was applied to Cox regression models to obtain subdistribution hazard ratios (HRs) and 95% CI for cancer-specific mortality considering other causes of death as competing risks, overall and separately by comorbidity burden class.

resultsThree comorbidity burden (low, moderate, and high) groups were identified. A total of 318 deaths (47 cancer-related) occurred. The IPTW-adjusted Cox regression analysis showed that RT omission was not associated with short-term, 5- and 10-year cancer-specific death (p = 0.202 and p = 0.536, respectively), regardless of comorbidity burden. However, RT omission could increase the risk of long-term cancer-specific death in women with low comorbidity burden (HR = 1.98, 95% CI = 1.17, 3.33), which warrants further study.

conclusionsOmission of RT after BCS is not associated with an increased risk of cancer-specific death and is deemed a reasonable treatment option for older women with moderate to high comorbidity burden.

Indexed as

Breast NeoplasmsAgedComorbidityFemaleHumansMastectomy, SegmentalMedicareNeoplasm StagingRadiotherapy, AdjuvantSEER ProgramTreatment OutcomeUnited Statescancer-specific mortalitycomorbidity burdenlatent class analysislow-risk breast cancerradiotherapyrisk stratification

Identifiers

PMID37706222
PMCPMC10557861
OpenAlexW4386726328

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.