Factors influencing the effect of age on prognosis in XXXX : population based study.

@entity1 @entity5 @entity258 @entity0
OBJECTIVE: To investigate whether young age at diagnosis is a negative prognostic factor in primary @entity0 and how stage of disease at diagnosis and treatment influences such an association. DESIGN: Retrospective cohort study based on a population based database of @entity1 with @entity0 containing detailed @entity5 characteristics, treatment regimens, and survival. SETTING: Denmark. SUBJECTS: 10 356 @entity1 with primary @entity0 who were less than 50 years old at diagnosis. MAIN OUTCOME MEASURES: Relative risk of dying within the first 10 years after diagnosis according to age at diagnosis after adjustment for known prognostic factors and expected mortality. RESULTS: Overall, young @entity1 with @entity258 who did not receive adjuvant treatment had a significantly increased risk of dying; risk increased with decreasing age at diagnosis (adjusted relative risk: 45-49 years (reference): 1; 40-44 years: 1.12 (95% confidence interval 0.89 to 1.40); 35-39 years: 1.40 (1.10 to 1.78); <35 years: 2.18 (1.64 to 2.89). However, no similar trend was seen in @entity1 who received adjuvant cytotoxic treatment. The increased risk in younger @entity1 who did not receive adjuvant treatment compared with those who did remained when @entity1 were grouped according to presence of node negative disease and by @entity5 size. CONCLUSION: The negative prognostic effect of young age is almost exclusively seen in @entity1 diagnosed with @entity258 who did not receive adjuvant cytotoxic treatment. These results suggest that young @entity1 with @entity0 , on the basis of age alone, should be regarded as high risk @entity1 and be given adjuvant cytotoxic treatment.
