Limitations of performance status assessment in elderly with acute myeloid leukemia

Carbonell, Ana Lúcia Ippolito; Chauffaille, Maria de Lourdes Lopes Ferrari

doi:10.1016/j.bjhh.2015.03.007

Cited by 10 publications

(5 citation statements)

References 12 publications

(18 reference statements)

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“…There are indications from some studies that performance status assessment does not give the entire quality of life picture of the patient such that while PS gives adequate information on functional autonomy of the patient, it provides limited information on other aspects of health that are important to the patient. 11 This study reveals that the mean age of these men presenting with metastatic hormone naïve prostate cancer is 70.62 ± 7.34 which is similar to ndings from other studies. 12,13 The median serum total prostate-speci c antigen (tPSA) of 83.70(IQR 47.90-107.00) is also similar to ndings from other studies as well.…”

Section: Discussionsupporting

confidence: 90%

Defining the relationship between clinician-preferred ECOG performance status and patient-reported health-related quality of life scores in men with metastatic hormone-naïve prostate cancer

Nnabugwu,

Obikeze,

Nnabugwu

et al. 2024

Preprint

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Background Performance status and health-related quality of life (HRQoL) are important parameters in the management of metastatic prostate cancer. The clinician-preferred Eastern Cooperative Oncology Group performance status (ECOG-PS) may not relate with the patient-described HRQoL because the later puts into consideration some aspects of health that are not captured by the former. The aim of this study is to define the relationship between clinician-preferred ECOG-PS and the patient-determined HRQoL in men with metastatic hormone-naïve prostate cancer (mPCa). Methods An analytical cross-sectional study recruiting patients presenting with mPCa in Enugu, southeast Nigeria. Two clinicians agreed on an ECOG-PS score for each study participant who in turn completed the FACT-P and the EQ-5D-5L questionnaires with interviewer-assistance where necessary. Other medical information was retrieved from the records. ANOVA and chi-square tests were used to compare available data across ECOG-PS preferences and ordinal logistic regression was used to determine the FACT-P questionnaire items that related significantly with the ECOG-PS preferences. Results Of the 224 participants (mean age: 70.62 ± 7.34), about 60.7% had ≥ 12years of formal education and 84.9% had ISUP grade ≥ 3 cancer. In all, 22.8%, 55.8%, 21.0% and 0.4% were ECOG-PS 1, ECOG-PS 2, ECOG-PS 3 and ECOG-PS 4 respectively while the mean FACT-P score, EQ-HVI and EQ-VAS score were 80.18 ± 17.56, 0.524 ± 0.324 and 60.43 ± 9.91% respectively. The FACT-P score (p = 0.002), EQ-HVI (p < 0.001) and EQ-VAS score (p < 0.001) varied significantly across the ECOG-PS categories. Within the FACT-P, only questionnaire items GP3 (p = 0.024) and GP7 (p < 0.001) of the PWB domain, and items GF5 (p = 0.009) and GF6 (p = 0.003) of the FWB domain related strongly with the ECOG-PS categories. Conclusion There are indications that HRQoL questionnaire items that have to do with impairment in physical role functioning relate strongly with ECOG-PS categories.

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Section: Discussionsupporting

confidence: 90%

Defining the relationship between clinician-preferred ECOG performance status and patient-reported health-related quality of life scores in men with metastatic hormone-naïve prostate cancer

Nnabugwu,

Obikeze,

Nnabugwu

et al. 2024

Preprint

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“…40,[42][43][44] Medical oncologists, having recognized the link between geriatric conditions and cancer treatment outcomes more than 2 decades ago, have developed [32][33][34] and validated 32,34 chemotherapy toxicity risk prediction tools that evaluate key health domains in older adults (e.g., functional status, comorbidity, cognition, and nutritional status) and predict the occurrence of grade 3 or higher adverse events according to the Common Terminology Criteria for Adverse Events 45 from chemotherapy with higher accuracy than traditional oncology performance measures (e.g., Karnofsky performance status). 46,47 As a result, geriatric assessment is now recommended by ASCO before chemotherapy initiation in older adults. 48 However, in radiation oncology, the data are nascent, and little is known about the relevance of geriatric assessment to outcomes from RT.…”

Section: Disparities In the Care Of Older Adults: A Radiation Oncologist's Perspectivementioning

confidence: 99%

Care Disparities Across the Health Care Continuum for Older Adults: Lessons From Multidisciplinary Perspectives

Dharmarajan

Presley

Wyld

2021

American Society of Clinical Oncology Educational Book

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Older adults comprise a considerable proportion of patients with cancer in the world. Across multiple cancer types, cancer treatment outcomes among older age groups are often inferior to those among younger adults. Cancer care for older individuals is complicated by the need to adapt treatment to baseline health, fitness, and frailty, all of which vary widely within this age group. Rates of social deprivation and socioeconomic disparities are also higher in older adults, with many living on reduced incomes, further compounding health inequality. It is important to recognize and avoid undertreatment and overtreatment of cancer in this age group; however, simply addressing this problem by mandating standard treatment of all would lead to harms resulting from treatment toxicity and futility. However, there is little high-quality evidence on which to base these decisions, because older adults are poorly represented in clinical trials. Clinicians must recognize that simple extrapolation of outcomes from younger age cohorts may not be appropriate because of variance in disease stage and biology, variation in fitness and treatment tolerance, and reduced life expectancy. Older patients may also have different life goals and priorities, with a greater focus on quality of life and less on length of life at any cost. Health care professionals struggle with treatment of older adults with cancer, with high rates of variability in practice between and within countries. This suggests that better national and international recommendations that more fully address the needs of this special patient population are required and that primary research focused on the older age group is urgently required to inform these guidelines.

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“…Thirteen percent of all participants were dependent in 1 or more ADL/IADL (20% of younger adults vs. 5% of older adults). Only 5% of all participants had a patient-reported KPS < 80% and 2.5% had a physician-reported KPS < 80% (KPS ≥ 80% indicates good performance status [ 30 ]). There was more variability on the Physical Functioning subscale of the 36-item Short Form Health Survey (SF-36) with a mean score for all participants of 77 (SD = 20) and a range of 25–100 on a scale of 0–100 [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

The Sickle Cell Disease Functional Assessment (SCD-FA) tool: a feasibility pilot study

Oyedeji

Hall

Luciano³

et al. 2022

Pilot Feasibility Stud

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Background The life expectancy for individuals with sickle cell disease (SCD) has greatly increased over the last 50 years. Adults with SCD experience multiple complications such as cardiopulmonary disease, strokes, and avascular necrosis that lead to limitations that geriatric populations often experience. There are no dedicated instruments to measure functional decline and functional age to determine risk of future adverse outcomes in older adults with SCD. The objective of this study was to assess the feasibility of performing the Sickle Cell Disease Functional Assessment (SCD-FA). Methods We enrolled 40 adults with SCD (20 younger adults aged 18–49 years as a comparison group and 20 older adults aged 50 years and older) in a single-center prospective cohort study. Participants were recruited from a comprehensive sickle cell clinic in an academic center in the southeastern United States. We included measures validated in an oncology geriatric assessment enriched with additional physical performance measures: usual gait speed, seated grip strength, Timed Up and Go, six-minute walk test, and 30-second chair stand. We also included an additional cognitive measure, which was the Montreal Cognitive Assessment, and additional patient-reported measures at the intersection of sickle cell disease and geriatrics. The primary outcome was the proportion completing the assessment. Secondary outcomes were the proportion consenting, duration of the assessment, acceptability, and adverse events. Results Eighty percent (44/55) of individuals approached consented, 91% (40/44) completed the SCD-FA in its entirety, and the median duration was 89 min (IQR 80–98). There were no identified adverse events. On the acceptability survey, 95% (38/40) reported the length as appropriate, 2.5% (1/40) reported a question as upsetting, and 5% (2/40) reported portions as difficult. Exploratory analyses of physical function showed 63% (25/40) had a slow usual gait speed (< 1.2 m/s). Conclusion The SCD-FA is feasible, acceptable, and safe and physical performance tests identified functional impairments in adults with SCD. These findings will inform the next phase of the study where we will assess the validity of the SCD-FA to predict patient-important outcomes in a larger sample of adults with SCD.

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Limitations of performance status assessment in elderly with acute myeloid leukemia

Cited by 10 publications

References 12 publications

Defining the relationship between clinician-preferred ECOG performance status and patient-reported health-related quality of life scores in men with metastatic hormone-naïve prostate cancer

Defining the relationship between clinician-preferred ECOG performance status and patient-reported health-related quality of life scores in men with metastatic hormone-naïve prostate cancer

Care Disparities Across the Health Care Continuum for Older Adults: Lessons From Multidisciplinary Perspectives

The Sickle Cell Disease Functional Assessment (SCD-FA) tool: a feasibility pilot study

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