602 Evaluation of Elderly Patients (&gt;70 Years Old) Enrolled in Phase I Clinical Trials at University of Texas Health Science Center at San Antonio-Cancer Therapy Research Center From 2009–2011

Rowe, Jean; Patel, Shiven B.; Mazo-Canola, Marcela; Parra, Augusto; Kelly, Kate; Weitman, Steven; Karnad, Anand B.

doi:10.1016/s0959-8049(12)72399-7

Cited by 3 publications

(4 citation statements)

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“…Patients were categorized as greater than 70 years of age or less than 70 years of age, based on commonly used oncological age cutoffs (16). Chart review was performed by P.A.…”

Section: Bone Tumor Cryoablationmentioning

confidence: 99%

Complications of Percutaneous Bone Tumor Cryoablation: A 10-year Experience

Auloge¹,

Cazzato²,

Rousseau³

et al. 2019

Radiology

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Background: Percutaneous cryoablation has been shown to be effective in the management of painful bone tumors. However, knowledge of the complication rate and risk factors for complication is currently lacking. Purpose:To report the complication rate and associated risk factors for bone tumor cryoablation. Materials and Methods:This retrospective study reviewed complications in 239 consecutive patients (131 men and 108 women; median age, 64 years; age range, 6-86 years) who underwent cryoablation of 320 primary or metastatic bone tumors between January 2008 and November 2017. Common Terminology Criteria for Adverse Events was used to categorize complications as major (grade 3-4) or minor (grade 1-2). Multivariable analysis was performed for variables with P values less than .20, including age, tumor location, adjacent critical structures, number of cryoprobes, and Eastern Cooperative Oncology Group performance status (ECOG-PS).Results: Among the 320 tumors, the total complication rate was 9.1% (29 of 320; 95% confidence interval [CI]: 6%, 12.2%). The major complication rate was 2.5% (eight of 320; 95% CI: 0.8%, 4.2%), with secondary fracture the most frequent complication (1.2% [four of 320]; mean delay, 71 days); cryoablation site infection, tumor seeding, bleeding, and severe hypotension were each observed in 0.3% (one of 320) of procedures. Minor complications included postprocedural pain (2.2% [seven of 320]), peripheral neuropathy (0.9% [three of 320]), and temporary paresthesia (0.9% [three of 320]). For all complications, associated risk factors included ECOG-PS greater than 2 (odds ratio [OR], 3.1 [95% CI: 3, 7.6]; P = .01), long-bone cryoablation (OR, 17.8 [95% CI: 2.3, 136.3]; P = .01), and use of more than three cryoprobes (OR, 2.5 [95% CI: 1.0, 6.0]; P = .04); for major complications, associated risk factors included age greater than 70 years (OR, 7.1 [95% CI: 1.6, 31.7]; P = .01) and use of more than three cryoprobes (OR, 23.6 [95% CI: 2.8, 199.0]; P = .01). Conclusion:Bone tumor cryoablation is safe, with a 2.5% rate of major complications, most commonly secondary fracture (1.2%). Major complications are associated with age greater than 70 years and use of more than three cryoprobes.

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“…Patients were categorized as greater than 70 years of age or less than 70 years of age, based on commonly used oncological age cutoffs (16). Chart review was performed by P.A.…”

Section: Bone Tumor Cryoablationmentioning

confidence: 99%

Complications of Percutaneous Bone Tumor Cryoablation: A 10-year Experience

Auloge¹,

Cazzato²,

Rousseau³

et al. 2019

Radiology

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“…At present most individuals with HF are elderly because of the progressive aging of the population . In the past, individuals aged 65 and older were regarded as elderly, but given the aging of the population, the cut‐off for the elderly age bracket has been shifting toward 70 to 80 recently . In the present study, we focused on individuals aged 80 and older.…”

Section: Discussionmentioning

confidence: 99%

“…1 In the past, individuals aged 65 and older were regarded as elderly, but given the aging of the population, the cut-off for the elderly age bracket has been shifting toward 70 to 80 recently. 5,[21][22][23][24] In the present study, we focused on individuals aged 80 and older. Importantly, these aged patients are often underrepresented in or excluded from large clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Estimated Pulmonary Artery Systolic Pressure and Mortality in Older‐Elderly Heart Failure Patients

Matsushita

Sakata

Satoh

et al. 2018

J American Geriatrics Society

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OBJECTIVES To evaluate the association between high estimated pulmonary artery systolic pressure (ePASP) obtained by echocardiography and 1‐year mortality in patients with acute heart failure (HF), comparing findings in individuals aged 80 and older with those of individuals younger than 80. DESIGN Retrospective cohort study. SETTING Kyorin University Hospital. PARTICIPANTS Individuals with acute decompensated HF (N = 335). MEASUREMENTS High ePASP was defined as a tricuspid regurgitation pressure gradient greater than 47 mmHg (ePASP >50 mmHg). Potential risk factors for 1‐year mortality were selected using univariate analysis followed by multivariate Cox regression analysis with backward stepwise selection of variables with P < .10 on univariate analysis to identify significant factors. RESULTS In individuals aged 80 and older, high ePASP (hazard ratio (HR)=3.07; 95% confidence interval (CI)=1.21–7.80), discharge medications without diuretics (HR=4.18, 95% CI=1.66–10.54), and discharge medications without renin–angiotensin–aldosterone system inhibitors (HR=3.38, 95% CI=1.29–8.81) were independent risk factors for 1‐year mortality. In contrast, low systolic blood pressure at admission was the sole independent risk factor for 1‐year mortality (HR=0.94, 95% CI=0.89–0.99) in those younger than 80. CONCLUSION High ePASP is a significant predictor of 1‐year mortality in individuals aged 80 and older with acute HF but not in those younger than 80. Elucidation of the pathophysiological mechanisms behind these findings should facilitate the development of more effective individualized therapies for older adults with acute HF. J Am Geriatr Soc 67:323–328, 2019.

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“…Multiple relapsed patients also do more poorly on phase I studies . In contrast, patients with cardiac ejection fraction >35%, modest renal dysfunction, or elderly healthy patients do well on phase I trials . Patient refusal is another barrier—African Americans and Latinos are two‐ and three‐fold more likely to decline phase I study enrollment, respectively .…”

Section: Discussionmentioning

confidence: 99%