Multidimensional geriatric assessment in treatment decision in elderly cancer patients: 6-year experience in an outpatient geriatric oncology service

Marenco, Daniela; Marinello, Renata; Berruti, Alfredo; Gaspari, Fabio; Stasi, M; Rosato, Rosalba; Bertetto, Oscar; Molaschi, M; Ciccone, Giovannino

doi:10.1016/j.critrevonc.2008.07.003

Cited by 49 publications

(52 citation statements)

References 28 publications

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“…The mean Charlson score was three (range 0-9), and the mean SCS score was nine (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Smoking (94.6%), cardiovascular disease (65%), COPD (59%) and hypertension (54%) were the most common comorbidities.…”

Section: 2 Cga Measures and Functionmentioning

confidence: 99%

“…[1][2][3] However, physiological aging is a heterogeneous process that does not necessarily correspond with chronological age. [4][5][6][7][8] The domains in a geriatric assessment are designed to ascertain the functional age of an older adult. This assessment identifies older adults with a diminished life expectancy and/or older adults who are at risk of hospitalization and functional decline 8,9 .…”

Section: Introductionmentioning

confidence: 99%

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Comprehensive Geriatric Assessment (CGA) of elderly lung cancer patients: A single-center experience

Gironés

Torregrosa

Maestu

et al. 2012

Journal of Geriatric Oncology

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Section: 2 Cga Measures and Functionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comprehensive Geriatric Assessment (CGA) of elderly lung cancer patients: A single-center experience

Gironés

Torregrosa

Maestu

et al. 2012

Journal of Geriatric Oncology

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“…36 However, an association has been reported between GA outcomes and treatment allocation in elderly cancer patients. 37 In this study, patients were prospectively assessed by a multidimensional geriatric and QOL assessment to demonstrate its applicability in a multicenter setting (a prerequisite for its further application in larger trials). Furthermore, it was our aim to investigate whether elderly MDS/AML patients with differing prognoses can be identified based on patient-related information.…”

Section: Discussionmentioning

confidence: 99%

“…In agreement with this, a recent investigation on the impact of a geriatric assessment in treatment decision-making in elderly patients revealed that the ADL's value correlates with treatment allocation (non-intensive care vs. intensive treatment efforts). 37 Several studies have shown baseline QOL parameters to be independent prognostic factors in different malignancies [42][43][44][45] underscoring the assumption that QOL scales add prognostic information to clinical measures and predict survival. 46 Patient ratings of physical symptoms (i.e.…”

Section: © F E R R a T A S T O R T I F O U N D A T I O Nmentioning

confidence: 99%

Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

et al. 2012

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Myelodysplastic syndromes and acute myeloid leukemia exemplify the complexity of treatment allocation in older patients as options range from best supportive care, non-intensive treatment (e.g. hypomethylating agents) to intensive chemotherapy/hematopoietic cell transplantation. Novel metrics for non-disease variables are urgently needed to help define the best treatment for each older patient. We investigated the feasibility and prognostic value of geriatric/quality of life assessments aside from established disease-specific variables in 195 patients aged 60 years or over with myelodysplastic syndromes/acute myeloid leukemia. These patients were grouped according to treatment intensity and assessed. Assessment consisted of eight instruments evaluating activities of daily living, depression, mental functioning, mobility, comorbidities, Karnofsky Index and quality of life. Patients with a median age of 71 years (range 60-87 years) with myelodysplastic syndromes (n=63) or acute myeloid leukemia (n=132) were treated either with best supportive care (n=47), hypomethylating agents (n=73) or intensive chemotherapy/hematopoietic cell transplantation (n=75). After selection of variables, pathological activities of daily living and quality of life/fatigue remained highly predictive for overall survival in the entire patient group beyond disease-related risk factors adverse cytogenetics and blast count of 20% or over. In 107 patients treated non-intensively activities of daily living of less than 100 (hazard ratio, HR 2.94), Karnofsky Index below 80 (HR 2.34) and quality of life/'fatigue' of 50 or over (HR 1.77) were significant prognosticators. Summation of adverse features revealed a high risk of death (HR 9.36). In-depth evaluation of older patients prior to individual treatment allocation is feasible and provides additional information to standard assessment. Patients aged 60 years or over with newly diagnosed myelodysplastic syndromes/acute myeloid leukemia and impairments in activities of daily living, Karnofsky Index below 80%, quality of life/'fatigue' of 50 or over, are likely to have poor outcomes.Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

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“…In einer prospektiven Studie, in die 571 siebzig-und über siebzigjährige Patienten eingeschlossen wurden, konnten Marenco et al zeigen, dass ADL und IADL Scores für die Th erapieplanung von Nutzen sein können. Sie zeigten, dass die Wahrscheinlichkeit einer aktiven Tumortherapie unterzogen zu werden, positiv mit einer hohen Punkteanzahl im IADL Score korrelierte, hingegen eine im ADL Score gemessene Abhängigkeit bei der Verrichtung alltäg-licher Handlungen gemeinsam mit niedrigen Körperge-wicht mit einem Th erapierückzug vergesellschaftet war [23].…”

Section: Funktioneller Statusunclassified

Komorbiditätsorientierte Onkologie – ein Überblick

Simanek

Wuensch

Edlinger

et al. 2010

Wien Klin Wochenschr

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Increasing life expectancy results in an increased number of elderly cancer patients. Comorbidities and functional impairment influence the patient's course of disease and the choice of antineoplastic treatment. The Comprehensive Geriatric Assessment (CGA) supports the appraisal of the patient's individual health characteristics, especially due to the fact that chronologic age does not always correlate with the patient's health. Next to the appraisal of comorbidities and functional impairment, nutritional state, cognitive impairment, psychological state, social support, quality of life and the patient's medication are recorded. The Society of Geriatric Oncology (SIOG) recommends the CGA in cancer patients older than seventy years. While planning a systemic antineoplastic therapy, renal, hepatic, cardiac and bone marrow insufficiencies have to be considered. Renal and hepatic impairment often cause in dose reduced antineoplastic treatment, whereas in patients with cardiac insufficiency liposomale substances and in patients with decreased bone marrow function growth factors are available. Additionally to the oncological treatment, an early involvement of palliative care specialists should be considered.

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Multidimensional geriatric assessment in treatment decision in elderly cancer patients: 6-year experience in an outpatient geriatric oncology service

Cited by 49 publications

References 28 publications

Comprehensive Geriatric Assessment (CGA) of elderly lung cancer patients: A single-center experience

Comprehensive Geriatric Assessment (CGA) of elderly lung cancer patients: A single-center experience

Parameters detected by geriatric and quality of life assessment in 195 older patients with myelodysplastic syndromes and acute myeloid leukemia are highly predictive for outcome

Komorbiditätsorientierte Onkologie – ein Überblick

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