Management of Prostate Cancer in Elderly Patients: Recommendations of a Task Force of the International Society of Geriatric Oncology

Droz, Jean‐Pierre; Albrand, G.; Gillessen, Silke; Hughes, Simon; Mottet, Nicolas; Oudard, Stéphane; Payne, Heather; Puts, Martine; Zulian, Gilbert; Balducci, Lodovico; Aapro, Matti

doi:10.1016/j.eururo.2016.12.025

Cited by 186 publications

(162 citation statements)

References 55 publications

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“…Any life‐prolonging effect from CurTrt must in these patients be weighed against the risk of adverse treatment‐related effects and death from other causes than PCa 19‐21 . Studies have indicated that treatment decisions in PCa patients are primarily based on chronological age rather than biological age 7,22‐27 . Undertreatment of healthy senior adults with high‐risk PCa may thus contribute to the described high incidence of death from PCa in the elderly population 5,6,20,21 …”

Section: Introductionmentioning

confidence: 99%

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

et al. 2020

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Background The association between curative treatment (CurTrt) and mortality in senior adults (≥70 years) with high‐risk prostate cancer (PCa) is poorly documented. In a population‐based cohort we report temporal trends in treatment and PCa‐specific mortality (PCSM), investigating the association between CurTrt and mortality in senior adults with high‐risk PCa, compared to findings in younger men (<70 years). Methods Observational study from the Cancer Registry of Norway. Patients with high‐risk PCa were stratified for three diagnostic periods (2005‐08, 2009‐12 and 2013‐16), age (<70, vs ≥70) and primary treatment (CurTrt: Radical prostatectomy (RP), Radiotherapy (RAD) vs no curative treatment (NoCurTrt)). Competing risk and Kaplan‐Meier methods estimated PCSM and overall mortality (OM), respectively. Multivariable logistic regression models estimated odds for CurTrt, and multivariable Fine Gray and Cox regression models evaluated the hazard ratios for PCSM and OM. Results Of 19 763 evaluable patients, 54% were aged ≥70 years. Senior adults had more unfavorable PCa characteristics than younger men. Across diagnostic periods, use of CurTrt increased from 15% to 51% in men aged ≥70 and 65% to 81% in men aged < 70 years. With median five years follow‐up, PCSM decreased in all patients (P < .05), in the third period restricted to senior adults. In all patients NoCurTrt was associated with three‐fold higher 5‐year PCSM and two‐fold higher OM compared to CurTrt. Conclusions In high‐risk PCa patients, increased use of CurTrt, greatest in senior men, was observed along with decreased PCSM and OM in both senior and younger adults. CurTrt should increasingly be considered in men ≥70 years.

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Section: Introductionmentioning

confidence: 99%

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

et al. 2020

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“…Comprehensive geriatric assessment has been shown to be associated with a higher probability of completing a treatment course, fewer modifications of treatment, and lower toxicity [185,186].…”

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confidence: 99%

Management of Patients with Advanced Prostate Cancer: The Report of the Advanced Prostate Cancer Consensus Conference APCCC 2017

et al. 2018

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The second Advanced Prostate Cancer Consensus Conference APCCC 2017 did provide a forum for discussion and debates on current treatment options for men with advanced prostate cancer. The aim of the conference is to bring the expertise of world experts to care givers around the world who see less patients with prostate cancer. The conference concluded with a discussion and voting of the expert panel on predefined consensus questions, targeting areas of primary clinical relevance. The results of these expert opinion votes are embedded in the clinical context of current treatment of men with advanced prostate cancer and provide a practical guide to clinicians to assist in the discussions with men with prostate cancer as part of a shared and multidisciplinary decision-making process.

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“…Der G8-Fragebogen wurde 2006 von Bellera et al als Screening Tool konzipiert, um onkologisch-geriatrische Patienten zu erkennen, die von einem weiterführenden Comprehensive Geriatric Assessment (CGA) profitieren [5]. Der G8-Fragebogen wird bei Prostatakarzinompatienten > 70 Jahren von der SIOG [9] und von der europäischen Gesellschaft für Urologie (EAU) [6] empfohlen.…”

Section: Aufbau Und Struktur Des G8-fragebogensunclassified

“…Um die genannten Schwächen des G8-Fragebogenscreenings zu beheben, wird von der Task Force der SIOG mittlerweile empfohlen, das Screening zur verbesserten Patientenselektion mit einem kognitiven Screeningtool (z. B. mini-COG™) zu kombinieren [9]. Andere Ansätze sind, das geriatrische Screening von vornherein durch ein verkürztes geriatrisches Assessment (ADL, CISR-G, Ernährungszustand -Frage nach Gewichtsverlust in den letzten 3 Monaten) zu ersetzten.…”

Section: Diskussionunclassified

Der G8-Fragebogen als geriatrisches Screening-Tool in der Uroonkologie

et al. 2019

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ZusammenfassungDer G8-Fragebogen ist ein von der SIOG und EAU empfohlenes geriatrisches Screening-Tool, das zum Zeit- und Ressourcenschonen einem kompletten geriatrischen Assessment („comprehensive geriatric assessment“, CGA) vorgeschaltet werden kann. Die Anwendung des Fragebogens hat sich in unserem klinischen Alltag bewährt, da die 8 Items schnell und problemlos in 4 – 5 Minuten im Stil einer Checkliste auch von nicht geriatrisch geschultem Personal bearbeitet werden können. Mittlerweile ist der G8-Fragebogen in der geriatrischen Onkologie ein etabliertes Screening-Tool. Mehrfach wurde in Studien bewiesen, dass er einen unabhängigen Vorhersagewert in Bezug auf das Gesamtüberleben von Patienten hat. Kritische Aspekte bei der Anwendung bleiben seine relativ geringe Testspezifität (60 %), sein Fokus auf Ernährungsaspekte und mögliche Interobserverdifferenzen. Diese Aspekte sollten vom Anwender gekannt und beachtet werden.

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Management of Prostate Cancer in Elderly Patients: Recommendations of a Task Force of the International Society of Geriatric Oncology

Cited by 186 publications

References 55 publications

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

Increased curative treatment is associated with decreased prostate cancer‐specific and overall mortality in senior adults with high‐risk prostate cancer; results from a national registry‐based cohort study

Management of Patients with Advanced Prostate Cancer: The Report of the Advanced Prostate Cancer Consensus Conference APCCC 2017

Der G8-Fragebogen als geriatrisches Screening-Tool in der Uroonkologie

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