Does the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), predict mortality in cancer patients? Results of a prospective observational trial

Giantin, Valter; Valentini, Elisabetta; Iasevoli, Mario; Falci, Cristina; Siviero, Paola; Luca, Elisabetta De; Maggi, Stefania; Martella, Bruno; Orrù, Graziella; Crepaldi, Gaetano; Monfardini, S.; Terranova, O.; Manzato, Enzo

doi:10.1016/j.jgo.2013.04.008

Cited by 51 publications

(40 citation statements)

References 39 publications

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“…These associations have repetitively been shown in nonrenal patients as well as community-dwelling older people (9)(10)(11)(49)(50)(51)(52)(53). Although older age has been associated with decreased survival in patients on dialysis (54)(55)(56)(57), other studies found that age alone was not an independent predictor of outcome (58,59).…”

Section: Discussionmentioning

confidence: 98%

Functional and Cognitive Impairment, Frailty, and Adverse Health Outcomes in Older Patients Reaching ESRD—A Systematic Review

Kallenberg¹,

Kleinveld²,

Dekker

et al. 2016

CJASN

153

124

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Background and objectives Older patients reaching ESRD have a higher risk of adverse health outcomes. We aimed to determine the association of functional and cognitive impairment and frailty with adverse health outcomes in patients reaching ESRD. Understanding these associations could ultimately lead to prediction models to guide tailored treatment decisions or preventive interventions.Design, setting, participants, & measurements We searched MEDLINE, Embase, Web of Science, CENTRAL, CINAHL, PsycINFO, and COCHRANE for original studies published until February 8, 2016 reporting on the association of functional or cognitive impairment or frailty with adverse health outcome after follow-up in patients reaching ESRD either with or without RRT.Results Of 7451 identified citations, we included 30 articles that reported on 35 associations. Mean age was .60 years old in 73% of the studies, and geriatric conditions were highly prevalent. Twenty-four studies (80%) reported on functional impairment, seven (23%) reported on cognitive impairment, and four (13%) reported on frailty. Mortality was the main outcome measure in 29 studies (97%), and one study assessed functional status trajectory. In 34 of 35 (97%) associations reported, functional or cognitive impairment or frailty was significantly and independently associated with adverse health outcomes. The majority of studies (83%) were conducted in selected patient populations, mainly patients on incident dialysis.Conclusions Functional and cognitive impairment and frailty in patients reaching ESRD are highly prevalent and strongly and independently associated with adverse health outcomes, and they may, therefore, be useful for risk stratification. More research into their prognostic value is needed.

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Section: Discussionmentioning

confidence: 98%

Functional and Cognitive Impairment, Frailty, and Adverse Health Outcomes in Older Patients Reaching ESRD—A Systematic Review

Kallenberg¹,

Kleinveld²,

Dekker

et al. 2016

CJASN

153

124

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show abstract

“…A systematic review of 51 studies that assessed the predictive value of geriatric assessment on survival concluded that several geriatric assessment domains, including performance status, geriatric depression scale, and nutritionalstatus,wereindependentpredictorsofmortality. 35,[43][44][45][46] A geriatric assessment can also predict early death-6 and 12 month overall survival-in older patients. 44,45 Several tools that use data from a geriatric assessment, such as the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) and the Cancer and Aging Research Group (CARG) chemotherapy toxicity calculator, have been developed to assist in the prediction of chemotherapy toxicity.…”

Section: Why Perform a Geriatric Assessment?mentioning

confidence: 99%

“…35,[43][44][45][46] A geriatric assessment can also predict early death-6 and 12 month overall survival-in older patients. 44,45 Several tools that use data from a geriatric assessment, such as the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) and the Cancer and Aging Research Group (CARG) chemotherapy toxicity calculator, have been developed to assist in the prediction of chemotherapy toxicity. The Pre-Operative Assessment of Cancer in the Elderly study also demonstrated that 30-day postoperative morbidity could be predicted by the number of impaired domains that were detected on a geriatric assessment.…”

Section: Why Perform a Geriatric Assessment?mentioning

confidence: 99%

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

Loh

Soto‐Pérez‐de‐Celis

Hsu

et al. 2018

JOP

134

105

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Aging is a heterogeneous process. Most newly diagnosed cancers occur in older adults, and it is important to understand a patient's underlying health status when making treatment decisions. A geriatric assessment provides a detailed evaluation of medical, psychosocial, and functional problems in older patients with cancer. Specifically, it can identify areas of vulnerability, predict survival and toxicity, assist in clinical treatment decisions, and guide interventions in routine oncology practice; however, the uptake is hampered by limitations in both time and resources, as well as by a lack of expert interpretation. In this review, we describe the utility of geriatric assessment by using an illustrative case and provide a practical approach to geriatric assessment in oncology. CASE J.K. is a 73-year-old man who presented to his primary care physician complaining of bright red blood per rectum. He has a medical history of coronary artery disease, hypertension, hyperlipidemia, and cerebrovascular disease. He is on aspirin, lisinopril, metoprolol, and atorvastatin. A subsequent colonoscopy revealed a 3-cm mass in his descending colon. Biopsy of the mass showed invasive adenocarcinoma. He underwent computed tomography scans of the chest, abdomen, and pelvis, which showed no evidence of metastases. A laparoscopic colectomy was performed, and his cancer was staged as T2N2 (stage III) and microsatellite stable. He is referred to you to discuss adjuvant chemotherapy.

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“…The comprehensive geriatric assessment (CGA) is considered by many to be the "gold standard" and is an effective clinical tool for identifying frailty in elderly patients (13,14). The CGA has demonstrated utility for the management of various geriatric problems including prevention of institutionalization and maintenance of independence, prevention of delirium in hospitalized patients, falls, and hospital readmission (15)(16)(17). It can also provide information about life expectancy and functional reserve as well as tolerance to and toxicity of chemotherapy (18,19).…”

Section: Introductionmentioning

confidence: 99%

Utility of the Edmonton Frail Scale in identifying frail elderly patients during treatment of colorectal cancer

Meyers

Al-Shamsi

Rask

et al. 2017

J. Gastrointest. Oncol.

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Does the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), predict mortality in cancer patients? Results of a prospective observational trial

Cited by 51 publications

References 39 publications

Functional and Cognitive Impairment, Frailty, and Adverse Health Outcomes in Older Patients Reaching ESRD—A Systematic Review

Functional and Cognitive Impairment, Frailty, and Adverse Health Outcomes in Older Patients Reaching ESRD—A Systematic Review

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

Utility of the Edmonton Frail Scale in identifying frail elderly patients during treatment of colorectal cancer

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