Prediction of Chemotoxicity, Unplanned Hospitalizations and Early Death in Older Patients with Colorectal Cancer Treated with Chemotherapy

Abstract

Purpose: To identify risk factors for toxicity, unplanned hospitalization (UH) and early death (ED) in older patients with colorectal carcinoma (CRC) initiating chemotherapy. Methods: 215 patients over 70 years were prospectively included. Geriatric assessment was performed before treatment, and tumor and treatment variables were collected. The association between these factors and grade 3–5 toxicity, UH and ED (<6 months) was examined by using multivariable logistic regression. Score points were assigned to each risk factor. Results: During the first 6 months of treatment, 33% of patients developed grade 3–5 toxicity, 31% had UH and 23% died. Risk factors were, for toxicity, instrumental activities of daily living, creatinine clearance, weight loss and MAX2 index; for UH, Charlson Comorbidity Score, creatinine clearance, weight loss, serum albumin, and metastatic disease; and for ED, basic activities in daily living, weight loss, metastatic disease, and hemoglobin levels. Predictive scores were built with these variables. The areas under receiver operation characteristic (ROC) curves for toxicity, UH and ED were 0.70 (95% CI: 0.64–0.766), 0.726 (95% IC: 0.661–0.799) and 0.74 (95% IC: 0.678–0.809), respectively. Conclusion: Simple scores based on geriatric, tumor and laboratory characteristics predict severe toxicity, UH and ED, and may help in treatment planning.

A novel risk prediction nomogram for early death in patients with resected synchronous multiple primary colorectal cancer based on the SEER database

“…The primary outcome measures for this study were early all-cause and cancer-speci c (CSS) early death within 3 months of diagnosis. 14 The categorical variables were expressed as numbers and percentages (n,%), and the differences in the distribution of the variables between the training and validation cohorts were assessed using Pearson's chi-square test. Univariate logistic regression analysis was performed on the training cohorts to identify the risk factors for all-cause and cancer-speci c early death.…”

A Nomogram to Predict Survival in Patients With Locoregional Recurrent Nasopharyngeal Carcinoma Receiving Comprehensive Treatment

“…ALB was also added as a prognostic factor in constructing the nomogram in our study. According to the latest studies, ALB is strongly associated with all-cause mortality, including cancer, cardiovascular diseases, and respiratory diseases, and lower ALB is associated with an increased risk of death ( 38 – 42 ). This is further confirmed in all cancer types, The studies in cervical carcinoma and vulvar squamous cell carcinoma had proved the value of nutritional indicators as independent risk factors ( 31 , 43 ).…”

Falls prechemotherapy and toxicity‐related hospitalization during adjuvant chemotherapy for breast cancer in older women: Results from the prospective multicenter HOPE trial

“…1,2,[20][21][22] Prior studies have been limited to claims-based retrospective data, 1,2,21,22 heterogeneous samples of older patients with different cancer types, stage, and treatment regimens, and inconsistent findings. [23][24][25][26] Hence, whether fall history can independently identify those at risk for toxicity-related hospitalization during neoadjuvant or adjuvant breast cancer chemotherapy remains unknown.…”

“…However, in older adults with early breast cancer, the association between falls and risk for toxicity‐related hospitalization during chemotherapy remains unclear 1,2,20–22 . Prior studies have been limited to claims‐based retrospective data, 1,2,21,22 heterogeneous samples of older patients with different cancer types, stage, and treatment regimens, and inconsistent findings 23–26 . Hence, whether fall history can independently identify those at risk for toxicity‐related hospitalization during neoadjuvant or adjuvant breast cancer chemotherapy remains unknown.…”