Senior Adult Oncology Clinical Practice Guidelines in Oncology

Hurria, Arti; Browner, Ilene; Cohen, Harvey Jay; Denlinger, Crystal S.; deShazo, Mollie; Extermann, Martine; Ganti, Apar Kishor; Holland, Jimmie C.; Holmes, Holly M.; Karlekar, Mohana; Keating, Nancy L.; McKoy, June M.; Medeiros, Bruno C.; Mrózek, Ewa; O’Connor, Tracey; Petersdorf, Stephen H.; Rugo, Hope S.; Silliman, Rebecca A.; Tew, William P.; Walter, Louise C.; Weir, Alva B.; Wildes, Tanya M.

doi:10.6004/jnccn.2005.0032

Cited by 72 publications

(8 citation statements)

References 196 publications

(178 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The National Comprehensive Cancer Network (NCCN) and International Society of Geriatric Oncology (SIOG) recommend that a geriatric assessment be performed to guide healthcare providers with selecting the best cancer treatments for older adults (2, 34). The geriatric assessment has been emphasized at time points prior to the initiation of cancer treatment (3).…”

Section: Discussionmentioning

confidence: 99%

Patient-reported versus objectively-measured physical function and mortality risk among cancer survivors

Brown

Harhay

2016

Journal of Geriatric Oncology

View full text Add to dashboard Cite

Introduction This study characterized the relationship of patient-reported functional limitations, gait speed, and mortality risk among cancer survivors. Materials and Methods This study included cancer survivors from the Third National Health and Nutrition Survey. Patient-reported functional limitations were quantified by asking participants to assess their ability to complete five tasks: (1) walking ¼ mile, (2) walking up 10-steps, (3) stooping, crouching, kneeling, (4) lifting or carrying an object of 10 pounds, and (5) standing up from an armless chair. Gait speed was quantified using a 2.4-meter walk. Vital status was obtained through the United States National Center for Health Statistics. Results The study sample included 428 cancer survivors who averaged 72.1 years of age. The average number of patient-reported functional limitations was 1.8 (out of 5) and 66% of participants reported ≥1 functional limitation. Patient-reported functional limitations and gait speed were related, such that each functional limitation associated with a −0.08 meter/second slower gait speed (95% Confidence Interval: −0.10 to −0.06; P<0.001). During a median follow-up of 11-years, 329 (77%) participants died. In multivariable-adjusted analysis, patient-reported functional limitations and survival were related, such that each additional reported functional limitation was associated with a 19% increase in the risk of death (95% Confidence Interval: 9 to 29%; P<0.001). Discussion Patient-reported functional limitations are prevalent among cancer survivors, and associate with slower gait speeds and shorter survival. These data may provide increased insight on long-term prognosis and inform clinical decision-making by identifying subgroups of cancer survivors who may benefit from rehabilitative intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Patient-reported versus objectively-measured physical function and mortality risk among cancer survivors

Brown

Harhay

2016

Journal of Geriatric Oncology

View full text Add to dashboard Cite

show abstract

“…15,16 Additional short survey measures, such as the Vulnerable Elders Survey 13 (VES-13), which includes self-reported items on health, activities of daily living, and mobility, are being investigated in older adults with cancer and are included for consideration in the NCCN Guidelines for Senior Adult Oncology. 17,18 …”

Section: The Geriatric Assessmentmentioning

confidence: 99%

Geriatric Assessment in Older Patients with Breast Cancer

Klepin¹,

Mohile²,

Hurria³

2009

J Natl Compr Canc Netw

View full text Add to dashboard Cite

Most cases of breast cancer are diagnosed in older adults. Compared with younger women, older women as a group are at increased risk for breast-cancer-specific mortality and at higher risk for treatment-associated morbidity as well. At the same time, older women are less likely to be offered preventive care or adjuvant therapy for this disease. There are major gaps in evidence regarding the optimal evaluation and treatment of older women with breast cancer due to significant under-representation in clinical trials. Chronologic age alone is an inadequate predictor of treatment tolerance and benefit in this heterogeneous population. Multiple issues uniquely associated with aging have an impact on cancer care, including functional impairment, comorbidity, social support, cognitive function, psychological state, and financial stress. Applying geriatric principles and assessment to this older adult population would inform decision-making, by providing estimates of life expectancy and identifying individuals most vulnerable to morbidity. Ongoing research is seeking to identify which assessment tools can best predict outcomes in this population, and thus guide us in tailoring treatments to maximize benefits in older adults with breast cancer.

show abstract

“…While on the contrary, it’s reported that elderly patients can tolerate a standard approach instead of conservative therapy with few side effects when adjusted for performance status [29–32]. It has been suggested the inferior survival of elderly patients to that of younger patients is attributed to changes in tumor biological characteristics and inherent resistance to chemotherapy, although this hypothesis remains controversial [33, 34]. Elderly patients with EOC more likely suffer from early recurrence, recalcitrance, and platinum resistance than younger patients do [35].…”

Section: Introductionmentioning

confidence: 99%

Age is associated with prognosis in serous ovarian carcinoma

Deng

et al. 2017

J Ovarian Res

View full text Add to dashboard Cite

PurposeThe survival duration of elderly patients with epithelial ovarian carcinoma is shorter than that of their younger counterparts. This variation in survival duration is likely attributed to differences in the distribution of histological type or grade, International Federation of Gynecology and Obstetrics (FIGO) staging, and undertreatment, but this observation remains controversial. This study aimed to investigate the biological factors other than selection bias associated with the decreased survival of elderly patients with ovarian carcinoma.MethodsA total of 314 serous ovarian cancer (SOC) patients from Jiangsu Institute of Cancer Research (JICR, PRC) between 2002 and 2012 were retrospectively analyzed, and 774 cases from MD Anderson Cancer Center (MDACC, USA) between 1992 and 2012 were used for validation. The 8-hydroxy-2′-deoxyguanine (8-OHdG) concentration in leukocyte DNA was evaluated by using commercially available enzyme-linked immunosorbent assay kits, and tissue expression was assayed through immunohistochemistry. The associations between survival durations and covariates were assessed by using a Cox proportional hazards model and by conducting a log-rank test.ResultsAdvanced age ≥ 65 years was correlated with high histological grade (p = 0.02), performance status (p = 0.03), primary treatment (p = 0.00), and suboptimal surgery outcome (p = 0.04) in SOC patients from JICR. Age, FIGO stage, histological grade, and optimal surgery were independently associated with the progression-free survival (PFS; p = 0.03, p = 0.03, p = 0.02, and p = 0.04, respectively) and overall survival (OS; p = 0.02, p = 0.04, p = 0.02, and p = 0.02, respectively) of the SOC patients from JICR. The 8-OHdG concentration in the leukocyte DNA was higher in the elderly patients than in the younger cases. The high 8-OHdG concentration in the leukocyte DNA indicated poorer median OS (30.0 months, confidence interval [CI]: 23.5–36.5 vs. 42.8 months, [CI] 38.3–47.2) and PFS (14.6 months, [CI] 11.9–17.2 vs. 18.9 months, [CI] 14.4–23.4) than those of their corresponding counterparts in the SOC patients who achieved a clinical complete response from primary treatment.ConclusionsCompared with younger cases, elderly patients with SOC were commonly characterized by high tumor grade, poor performance status, and undertreatment. High 8-OHdG concentration in leukocyte DNA was associated with advanced age and poor prognosis in SOC patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s13048-017-0331-6) contains supplementary material, which is available to authorized users.

show abstract

Senior Adult Oncology Clinical Practice Guidelines in Oncology

Cited by 72 publications

References 196 publications

Patient-reported versus objectively-measured physical function and mortality risk among cancer survivors

Patient-reported versus objectively-measured physical function and mortality risk among cancer survivors

Geriatric Assessment in Older Patients with Breast Cancer

Age is associated with prognosis in serous ovarian carcinoma

Contact Info

Product

Resources

About