Comprehensive Geriatric assessment and its clinical impact in oncology

Maas, Huub; Janssen‐Heijnen, M.L.G.; Rikkert, Marcel G M Olde; Wymenga, A.N.M.

doi:10.1016/j.ejca.2007.08.002

Cited by 162 publications

(94 citation statements)

References 41 publications

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“…Finally, it is increasingly reported that chemotherapeutic agents can worsen the patient's cognitive status (36)(37)(38). Thus, it is obvious those patients with cognitive impairment at the start of chemotherapy are more vulnerable, and that their vulnerability can be worsened by chemotherapeutic agents (39,40).…”

Section: Discussionmentioning

confidence: 99%

“…MMSE and MoCA for cognitive status, while the MoCA is more sensitive to detect mild cognitive impairment that which explains the greater percentage of cognitive impairment measured by this scale. We chose the CCI to evaluate the number of co-morbidities but their severity is probably more important than their quantity since an accumulation of co-morbidities was not found to be a good predictor of the patient's tolerance to chemotherapy (40,41). In agreement with this assumption, the CIRS-G could be a more appropriate scale.…”

Section: Discussionmentioning

confidence: 99%

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Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition

Dubruille

Libert

Roos

et al. 2015

Journal of Geriatric Oncology

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Little is known about the reliability of G8 screening tool and the prognostic value of clinical parameters within the Comprehensive Geriatric Assessment (CGA) in clinically fit older patients with haematological malignancies. This study was performed to assess the reliability of G8 as a screening tool and to determine the predictive value of CGA items in terms of one-year overall survival (OS). G8 and CGA were proposed to 107 consecutive patients (65-89yrs) with haematological malignancies that were judged clinically fit to receive chemotherapy. Ninety patients were evaluable with both scales; 72% and 80% were defined as "vulnerable" when evaluated with G8 (≤14.5) or CGA (≥2 impairments) respectively. The area under ROC-curve of G8 compared to CGA was 0.749 ± 0.051. Neither G8 nor CGA total score were predictive of one-year OS. However, age (HR=1.09, 95%CI: 1.009-1.185; p=0.029), diagnosis (HR=5.99, 95%CI: 2.322-15.428; p<0.001) and cognitive status (HR=3.50, 95%CI: 1.132-10.849; p=0.030) were predictive of OS. We conclude that in our selected haematological patients 1) the G8 score does not help selecting patients for CGA 2) the G8 and CGA total score do not predict OS 3) in addition to the age and disease itself, cognitive impairment appears to be a powerful prognostic factor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition

Dubruille

Libert

Roos

et al. 2015

Journal of Geriatric Oncology

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“…Our findings underscore this point and are supported by both the geriatric and cancer literature linking individual clinical, function, and psychosocial GA domains to increased risk of worse treatment tolerance and mortality. 21,[30][31][32]35,38,64 The added benefit of multidimensional GA is that it provides physicians and patients/families with information to guide clinical management and to identify vulnerabilities that may be mitigated by interdisciplinary interventions. Specifically, GA can identify reversible problems that may interfere with cancer treatment, such as poor mental health, insufficient social support, or functional limitations that might be modified to reduce their impact on treatment and/or treatment effects.…”

Section: Geriatric Assessment In Older Breast Cancer Survivorsmentioning

confidence: 99%

Older Breast Cancer Survivors: Geriatric Assessment Domains Are Associated With Poor Tolerance of Treatment Adverse Effects and Predict Mortality Over 7 Years of Follow-Up

Clough‐Gorr

Stuck

Thwin

et al. 2010

JCO

164

108

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A B S T R A C T PurposeTo evaluate geriatric assessment (GA) domains in relation to clinically important outcomes in older breast cancer survivors. MethodsSix hundred sixty women diagnosed with primary breast cancer in four US geographic regions (Los Angeles, CA; Minnesota; North Carolina; and Rhode Island) were selected with disease stage I to IIIA, age Ն 65 years at date of diagnosis, and permission from attending physician to contact. Data were collected over 7 years of follow-up from consenting patients' medical records, telephone interviews, physician questionnaires, and the National Death Index. Outcomes included self-reported treatment tolerance and all-cause mortality. Four GA domains were described by six individual measures, as follows: sociodemographic by adequate finances; clinical by Charlson comorbidity index (CCI) and body mass index; function by number of physical function limitations; and psychosocial by the five-item Mental Health Index (MHI5) and Medical Outcomes Study Social Support Survey (MOS-SSS). Associations were evaluated using t tests, 2 tests, and regression analyses. ResultsIn multivariable regression including age and stage, three measures from two domains (clinical and psychosocial) were associated with poor treatment tolerance; these were CCI Ն 1 (odds ratio [OR] ϭ 2.49; 95% CI, 1.18 to 5.25), MHI5 score less than 80 (OR ϭ 2.36; 95% CI, 1.15 to 4.86), and MOS-SSS score less than 80 (OR ϭ 3.32; 95% CI, 1.44 to 7.66). Four measures representing all four GA domains predicted mortality; these were inadequate finances (hazard ratio [HR] ϭ 1.89; 95% CI, 1.24 to 2.88; CCI Ն 1 (HR ϭ 1.38; 95% CI, 1.01 to 1.88), functional limitation (HR ϭ 1.40; 95% CI, 1.01 to 1.93), and MHI5 score less than 80 (HR ϭ 1.34; 95% CI, 1.01 to 1.85). In addition, the proportion of women with these outcomes incrementally increased as the number of GA deficits increased. ConclusionThis study provides longitudinal evidence that GA domains are associated with poor treatment tolerance and predict mortality at 7 years of follow-up, independent of age and stage of disease.

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“…Recent observations demonstrated that several geriatric conditions were predictive of outcome in older cancer patients in outpatient settings [6,11,12]. In the present study, we demonstrated that, in our population of 292 acutely hospitalized older cancer patients, most of whom were living independently prior to admission, geriatric conditions were highly prevalent, but none of the elements of the CGA were associated with mortality.…”

Section: Discussionmentioning

confidence: 55%

The Value of a Comprehensive Geriatric Assessment for Patient Care in Acutely Hospitalized Older Patients with Cancer

et al. 2011

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Introduction.A comprehensive geriatric assessment systematically collects information on geriatric conditions and is propagated in oncology as a useful tool when assessing older cancer patients.Objectives. The objectives were: (a) to study the prevalence of geriatric conditions in cancer patients aged >65 years, acutely admitted to a general medicine ward; (b) to determine functional decline and mortality within 12 months after admission; and (c) to assess which geriatric conditions and cancer-related variables are associated with 12-month mortality.Methods. This was an observational cohort study of 292 cancer patients aged >65 years, acutely admitted to the general medicine and oncology wards of two university hospitals and one secondary teaching hospital. Baseline assessments included patient characteristics, reason for admission, comorbidity, and geriatric conditions. Follow-up at 3 and 12 months was aimed at func-

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Comprehensive Geriatric assessment and its clinical impact in oncology

Cited by 162 publications

References 41 publications

Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition

Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: Major impact of cognition

Older Breast Cancer Survivors: Geriatric Assessment Domains Are Associated With Poor Tolerance of Treatment Adverse Effects and Predict Mortality Over 7 Years of Follow-Up

The Value of a Comprehensive Geriatric Assessment for Patient Care in Acutely Hospitalized Older Patients with Cancer

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