Does a Geriatric Oncology Consultation Modify the Cancer Treatment Plan for Elderly Patients?

Girre, V.; Falcou, Marie-Christine; Gisselbrecht, Mathilde; Gridel, G.; Mosseri, Véronique; Bouleuc, Carole; Poinsot, Rollon; Védrine, Lionel; Ollivier, L.; Garabige, Valérie; Pierga, Jean‐Yves; Dièras, Véronique; Mignot, L.

doi:10.1093/gerona/63.7.724

Cited by 178 publications

(110 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…35 Care should be used when applying these criteria in elderly patients because they are at higher risk for having other disease processes that may contribute to fatigue or weight loss (eg, second cancer, malnutrition, neglect, other organ dysfunction). Up to 50% of older patients have been found to have depression, 34,36 and patients should be specifically screened for depression and other disorders associated with fatigue (eg, hypothyroid, sleep apnea, anemia from a cause unrelated to CLL) before attributing fatigue to CLL. Although a lymphocyte doubling time of less than 6 months is considered an acceptable indication for treatment, 35 treatment on this basis alone is rarely indicated in the absence of other indications for therapy.…”

Section: When Should Elderly Patients Be Treated?mentioning

confidence: 99%

Treatment of older patients with chronic lymphocytic leukemia: key questions and current answers

Shanafelt

2013

Hematology

View full text Add to dashboard Cite

Despite the advanced age at onset, chronic lymphocytic leukemia (CLL) shortens the life expectancy of the majority of newly diagnosed patients. The management of elderly patients with CLL is more complex than that of younger patients due to the greater frequency of comorbidities and functional impairment as well as reduced organ function. Many of the recent advances in the care of CLL patients (prognostication, more intense combination therapy regimens) are of unclear relevance for elderly patients. This review addresses 5 key questions in the management of elderly patients with CLL: (1) why is classifying the "fitness" of CLL patients necessary; (2) what criteria should be used to classify patient fitness; (3) when should elderly patients be treated; (4) how should therapy be selected for elderly patients; and (5) which therapy is best (for this patient)?

show abstract

Section: When Should Elderly Patients Be Treated?mentioning

confidence: 99%

Treatment of older patients with chronic lymphocytic leukemia: key questions and current answers

Shanafelt

2013

Hematology

View full text Add to dashboard Cite

show abstract

“…One of the most frequent comorbidities in their patients with a median age of 79 years was depression, present or suspected in 53% of patients. Depression in particular is an example of a condition which will not be recognised in many patients without focussed screening 15 . Frail patients with associated comorbidities and especially, impaired cognitive function are the subgroup with highest risk of cancer treatment-related complications.…”

Section: Discussionmentioning

confidence: 99%

Locally advanced breast cancer in elderly patients

Hornová¹,

Bortlíček²,

Májková³

et al. 2017

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

Background. Although locally advanced breast cancer (LABC) is more common in the elderly population, there is little data on the clinical characteristics and survival of these patients. The aim of the present study was to compare different factors affecting survival in elderly patients with LABC. Methods. Retrospective analysis was carried out on a cohort of 80 patients aged 70 to 96 years, diagnosed with LABC defined as T3 N1, T4 N0, any N2 or N3, and M0. The prognostic impact of selected clinical parameters including age, comorbidities, tumour grade, HER2 status, tumour stage, local therapies, and systemic treatments was studied. Results. The median age of the patients was 79 years. The majority (n=53; 66%) had at least one significant comorbidity according to the Charlson score evaluation. The median overall survival was 50.6 months. As expected, hormonal therapy was the dominant mode of systemic treatment, but 24% also received at least one line of chemotherapy. Local therapies including surgery and/or radiotherapy were applied in 58% of patients. Conclusions. The diagnosis of LABC in the elderly is associated with poor prognosis. Age and serious comorbidities were negative prognostic factors.

show abstract

“…In a systemic review by Puts et al 2012 [10], four studies, all conducted in France, examined the impact of geriatric assessment on cancer treatment [22,23,24,25]. In two studies, geriatric assessment did not influence the treatment decision, whereas in the other two studies, it led to changes in the treatment plan in 40-50% of patients.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience

Rivoirard¹,

Chargari

Kullab³

et al. 2015

Chemotherapy

View full text Add to dashboard Cite

Background: The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized. Methods: In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment. Results: Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years. Conclusion: Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life.

show abstract

Does a Geriatric Oncology Consultation Modify the Cancer Treatment Plan for Elderly Patients?

Abstract: The geriatric oncology consultation led to a modification of the cancer treatment plan in more than one third of cases. Further studies are needed to determine whether these modifications improve the outcome of these older patients.

Cited by 178 publications

References 30 publications

Treatment of older patients with chronic lymphocytic leukemia: key questions and current answers

Treatment of older patients with chronic lymphocytic leukemia: key questions and current answers

Locally advanced breast cancer in elderly patients

Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience

Contact Info

Product

Resources

About