本研究报告了英国大型前瞻性乳腺癌老年女性（≥70 岁）队列中接受主要内分泌治疗 (PET) 治疗的女性的详细管理和结果。这是一项前瞻性、多中心观察性研究的计划外二次分析（年龄差距研究）。在基线和定期收集患者、肿瘤和治疗特征的数据，并记录肿瘤 RECIST 反应类别。直接研究随访期为 24 个月，长期生存数据从英国癌症登记处获得。年龄差距研究招募了 56 个乳房单位的 3316 名女性。对 505/3316 (15%) 名女性开始了主要内分泌治疗 (PET)；中位年龄为 84 岁（IQR 79-88），中位随访时间为 41.9 个月（IQR 27-60）。 205/505（40.6%）名患者死亡，160/205； 78% 与乳腺癌无关，45/205； 21.9% 与乳腺癌相关。多变量分析确定年龄较大（HR-1.055（95%置信区间：1.029-1.084）；P<0.001）和较高的查尔森指数（HR-1.166（1.086-1.252）；P<0.001）是全因死亡的危险因素，但转为手术（HR-0.372（0.152-0.914）；P = 0.031）具有保护作用。 3 级癌症（G1 与 G3 HR-0.28 (0.094-0.829)；P = 0.022

This study reports the detailed management and outcomes of women treated with Primary Endocrine Therapy (PET) in a large prospective UK cohort of older women (≥70) with breast cancer.This was an unplanned secondary analysis of a prospective, multicentre, observational study (The Age Gap study). Data were collected at baseline and regular intervals on patient, tumour and treatment characteristics with tumour RECIST response category recorded. Direct study follow-up was 24 months with longer-term survival data obtained from the UK cancer registry.The Age Gap study recruited 3316 women across 56 breast units. Primary endocrine therapy (PET) was initiated for 505/3316 (15 %) women; median age was 84 (IQR 79-88) with median follow-up 41.9 months (IQR 27-60). Death occurred in 205/505(40.6 %) patients, 160/205; 78 % non- Breast Cancer related, 45/205; 21.9 % Breast Cancer related. Multivariate analysis identified older age (HR-1.055(95 % Confidence Interval: 1.029-1.084); P < 0.001) and higher Charlson Index (HR-1.166 (1.086-1.252); P < 0.001) as risk factors for all-cause mortality, but conversion to surgery (HR-0.372(0.152-0.914); P = 0.031) was protective. Grade 3 cancer (G1 vs G3 HR-0.28 (0.094-0.829); P = 0.022 & G2 vs G3 HR-0.469 (0.226-0.973); P = 0.042), axillary positivity (axilla positivity HR-2.548 (1.321-4.816); P = 0.005) and change of endocrine therapy (HR-3.010 (1.532-5.913); P = 0.001) were associated with worse breast cancer specific survival (BCSS). RECIST category was not significantly associated with either overall survival or BCSS (P > 0.05).Early disease response and change of endocrine therapy are not significantly associated with overall survival, conversion to surgery is linked to improved outcome. Prognosis is largely determined by age and comorbidity in older women treated with PET.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.