Influence of geriatric consultation with comprehensive geriatric assessment on final therapeutic decision in elderly cancer patients

Chaïbi, P.; Magné, Nicolas; Breton, Sylvie; Chebib, Amale; Watson, Sarah; Duron, Jean‐Jacques; Hannoun, L.; Lefranc, Jean‐Pierre; Piette, F.; Ménégaux, Fabrice; Spano, Jean‐Philippe

doi:10.1016/j.critrevonc.2010.08.004

Cited by 175 publications

(109 citation statements)

References 32 publications

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“…In contrast, in a cohort study of 161 older men and women (mean age 82.4), GA influenced treatment decisions in 49% of cases. For 57% of these patients, the change was to increase intensity of therapy [72]. A similar pilot study undertaken in France of 105 patients with a median age of 79 demonstrated that the results of a GA consisting of a screening questionnaire undertaken by an oncologist with geriatric training influenced the treatment decision in 38.7% of patients [73].…”

Section: (Iii) the Impact Of Geriatric Assessment On Decision-making mentioning

confidence: 99%

“…For example, in a retrospective analysis of the phase 3 AGO-OVAR 3 study (Carboplatin/Paclitaxel compared to Cisplatin/Paclitaxel in the first-line setting following cytoreductive surgery for advanced ovarian cancer), 103 patients over the age of 70 were compared to the under 70 years group (n=676). Over 80% of the patients in this analysis were ECOG PS 0 or 1 and the mean age of patients over 70 was 73.5 (range [70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85]. The authors concluded that combination chemotherapy was tolerable in an older population but discontinuation rates were double in those over the age of 70 compared to the <70 group [40].…”

Section: (Ii) Chemotherapymentioning

confidence: 99%

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Improving outcomes for older women with gynaecological malignancies

Dumas

Ring

Butler

et al. 2016

Cancer Treatment Reviews

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The incidence of most gynaecological malignancies rises significantly with increasing age. With an ageing population, the proportion of women over the age of 65 with cancer is expected to rise substantially over the next decade. Unfortunately, survival outcomes are much poorer in older patients and evidence suggests that older women with gynaecological cancers are less likely to receive current standard of care treatment options. Despite this, older women are underrepresented in practice changing clinical studies. The evidence for efficacy and tolerability is therefore extrapolated from a younger; often more fit population and applied to in every day clinical practice to older patients with co-morbidities. There has been significant progress in the development of geriatric assessment in oncology to predict treatment outcomes and tolerability however there is still no clear evidence that undertaking a geriatric assessment improves patient outcomes. Clinical trials focusing on treating older patients are urgently required. In this review, we discuss the evidence for treatment of gynaecological cancers as well as methods of assessing older patients for therapy. Potential biomarkers of ageing are also summarised.

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Section: (Iii) the Impact Of Geriatric Assessment On Decision-making mentioning

confidence: 99%

Section: (Ii) Chemotherapymentioning

confidence: 99%

Improving outcomes for older women with gynaecological malignancies

Dumas

Ring

Butler

et al. 2016

Cancer Treatment Reviews

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“…Given the heterogeneity of the older population, integrating assessments to better biologically stage these patients should lead to better treatment decisions. There is a growing body of evidence supporting the use of comprehensive geriatric assessments in guiding treatment decisions in older patients with cancer [27][28][29][30][31][32] and in addition, there are assessment tools available to better predict tolerance and toxicity to chemotherapy in this population [33,34]. Treatment decisions for BTC in older patients should thus not be guided solely by the biological age of the patient, and active management should be considered for this patient population if deemed appropriate following clinical assessment.…”

Section: Discussionmentioning

confidence: 99%

Patterns of care and treatment outcomes in older patients with biliary tract cancer.

Horgan

McNamara

Aneja

et al. 2014

JCO

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Background: Although biliary tract cancers (BTC) are common in older age-groups, treatment approaches and outcomes are understudied in this population.Patients and Methods: Data from 913 patients diagnosed with BTC from January 1987 to July 2013 and treated at Princess Margaret Cancer Center, Toronto were analyzed. The differences in treatment patterns between older and younger patients were explored and the impact of age, patient and disease characteristics on survival outcomes was assessed.Results: Three hundred and twenty one patients ≥70 years were identified. Older patients were more likely to receive best supportive care, 40% (n = 130), compared to younger patients 26% (n = 154); p < 0.0001. On multivariable analysis, factors associated with receipt of surgery included stage I/II disease (p < 0.0001) and ECOG PS < 2 (p < 0.0001). Older age was not associated with lack of surgical intervention. In comparison, older age was associated with non-receipt of palliative chemotherapy (p = 0.0007). Similar survival benefit from treatment was seen in older and younger patients. Of 626 patients that underwent either surgery or palliative chemotherapy (n = 188), the median survival was 21.1 months (95% CI 19.0-27.9) in patients >70 years of age, and 21.1 months in younger patients (n = 438) (95% CI 19.5-24.5).Conclusion: In this large retrospective analysis, older patients with BTC are less likely to undergo an intervention. However, active therapy when given is associated with similar survival benefits, irrespective of age.

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“…Seul, 10% des personnes âgées présentant une dépression, recevrait des traitements adé-quats. L'évaluation psychologique, voire l'évaluation de psycho-gériatrie plus poussée [5], doivent systématiquement être proposées aux patients âgés, comme nous le recommande la SFPO (vous trouverez dans l'article de Sarah Dauchy et al toutes les échelles et questionnaires nécessaires pour les pratiquer).…”

Section: âGisme Des Psychologues Et Psychiatresunclassified

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2012

Psycho Oncologie

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Influence of geriatric consultation with comprehensive geriatric assessment on final therapeutic decision in elderly cancer patients

Cited by 175 publications

References 32 publications

Improving outcomes for older women with gynaecological malignancies

Improving outcomes for older women with gynaecological malignancies

Patterns of care and treatment outcomes in older patients with biliary tract cancer.

Contre l’âgisme et pour les super-vieux

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