Performance of the Multidimensional Geriatric Assessment and Multidimensional Prognostic Index in predicting negative outcomes in older adults with cancer

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

doi:10.1111/ecc.12585

Cited by 14 publications

(12 citation statements)

References 38 publications

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“…Despite several studies have been performed, current multidimensional instruments are not adequate to extensively stratify the risk for hospitalization and mortality in old people since influenced by different comorbidities and factors. Indeed, a considerable limit of these frailty scales is that different tools have been shown to be only effective in specific clinical conditions or settings (e.g., HF, cancer, or dementia; population-level frailty screening versus clinical screening) and, so far, no assessment scale is applicable to every elderly patient (83, 84, 86, 87). …”

Section: Mirnas In Cardiovascular Agingmentioning

confidence: 99%

microRNA in Cardiovascular Aging and Age-Related Cardiovascular Diseases

Lucia

Komici²,

Borghetti

et al. 2017

Front. Med.

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Over the last decades, life expectancy has significantly increased although several chronic diseases persist in the population, with aging as the leading risk factor. Despite improvements in diagnosis and treatment, many elderlies suffer from cardiovascular problems that are much more frequent in an older, more fragile organism. In the long term, age-related cardiovascular diseases (CVDs) contribute to the decline of quality of life and ability to perform normal activities of daily living. microRNAs (miRNAs) are a class of small non-coding RNAs that regulate gene expression at the posttranscriptional level in both physiological and pathological conditions. In this review, we will focus on the role of miRNAs in aging and age-related CVDs as heart failure, hypertension, atherosclerosis, atrial fibrillation, and diabetes mellitus. miRNAs are key regulators of complex biological mechanisms, representing an exciting potential therapeutic target in CVDs. Moreover, one major challenge in geriatric medicine is to find reliable biomarkers for diagnosis, prognosis, and prediction of the response to specific drugs. miRNAs represent a very promising tool due to their stability in the circulation and unique signature in CVDs. However, further studies are needed to investigate their translational potential in the real clinical practice.

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Section: Mirnas In Cardiovascular Agingmentioning

confidence: 99%

microRNA in Cardiovascular Aging and Age-Related Cardiovascular Diseases

Lucia

Komici²,

Borghetti

et al. 2017

Front. Med.

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“…The MPI then differs from other mortality indexes because it is based on a CGA, with each of the eight tests assessing one geriatric domain. Giantin and collaborators confirmed the good discriminatory power for 12-month mortality in a cohort of 160 cancer patients older than 70, and validated higher mortality prediction compared to a standard CGA [13]. Use of the MPI in clinical practice may provide a rapid and comprehensive evaluation of patients, to adapt the decisionmaking in oncology.…”

Section: Discussionmentioning

confidence: 81%

“…CGA has also shown a predictive value in identifying elderly patients with cancer who are exposed to a poor prognosis, including a higher risk of death during hospitalization [11]. Among the CGA-based assessment tools, the Multidimensional Prognostic Index (MPI) has shown a predictive interest in mortality at six months and 12 months in Italian patients aged 70 years and older with advanced cancers [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive geriatric assessment in older patients with cancer: an external validation of the Multidimensional Prognostic Index in a French prospective cohort study

Pocard

Valéro

et al. 2019

Preprint

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Background: Older patients with cancer require specific and individualized management. The Multidimensional Prognostic Index (MPI) based on the Comprehensive Geriatric Assessment (CGA) has shown a predictive interest in terms of mortality.Methods: From 2015 to 2017, consecutive patients ≥75 years old with cancer in Poitiers University Hospital referred to an oncogeriatric consultation. Patients underwent CGA with MPI that is categorized into three risk groups of mortality at one year.Results: Overall, 433 patients were included (women 42%; mean age 82.8±4.8 years). Most common tumor sites were prostate (23%), skin (17%), colorectum (15%) and breast (12%); 29% patients had a metastatic disease; 231 patients (53%) belonged to "MPI-1" group, 172 (40%) to "MPI-2" group and 30 patients (7%) were classified in "MPI-3" group. One-year mortality rate was 32% (23% in MPI-1, 41% in MPI-2 and 53% in MPI-3, p=0.024). All domains of MPI except cognition and living status were significantly associated with mortality at one-year, as well as tumor sites and metastatic status. Cox proportional hazard regression analysis, adjusted on age, gender, tumor sites and metastatic status, validated MPI as being associated with a higher mortality risk (p<0.0001). The prognostic value of MPI was confirmed by the area under the ROC curve at 0.826 (P <0.0001).Conclusion: Our study confirmed the predictive value of MPI for one-year mortality in older patients with cancer. This practical prognostic tool may help to optimize the management of these vulnerable patients.

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“…CGA has also shown predictive value in identifying elderly patients with cancer who are exposed to a poor prognosis, including a higher risk of death during hospitalization [11]. Among the CGAbased assessment tools, the Multidimensional Prognostic Index (MPI) has shown a predictive interest in mortality at 6 months and 12 months in Italian patients aged 70 years and older with advanced cancers [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive geriatric assessment in older patients with cancer: an external validation of the multidimensional prognostic index in a French prospective cohort study

Liuu

Valéro

et al. 2020

BMC Geriatr

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Background: Older patients with cancer require specific and individualized management. The 3-group Multidimensional Prognostic Index (MPI) based on the Comprehensive Geriatric Assessment (CGA) has shown a predictive interest in terms of mortality. The objective of our study was to assess the prognostic value of MPI for 1year mortality in an external prospective French cohort of elderly patients with cancer. Methods: From March 2015 to March 2017 a prospective single-center cohort study enrolled all patients with cancer, aged 75 years and older referred to the geriatric oncology clinic. We used a proportional hazard model for 1-year mortality adjusted for age, sex, tumor sites and metastatic status. C-statistics were used to assess the incremental predictive value of MPI index to these risk factors. Results: overall, 433 patients underwent CGA with MPI (women 42%; mean age 82.8 ± 4.8 years). The most common tumor sites were prostate (23%), skin (17%), colorectum (15%) and breast (12%); 29% of patients had a metastatic disease; 231 patients (53%) belonged to the "MPI-1" group, 172 (40%) to the "MPI-2" group and 30 patients were classified in the "MPI-3" group. One-year mortality rate was 32% (23% in MPI-1, 41% in MPI-2 and 53% in MPI-3, p = 0.024). All domains of MPI except cognition and living status were significantly associated with mortality at one-year, as well as tumor sites and metastatic status. Higher MPI was associated with a higher mortality risk (adjusted HR 1.56 [95%CI 1.70-2.09] and 1.72 [1.33-2.22] for MPI groups 2 and 3 compared to 1; p < 0.0001). Conclusions: In addition to established risk factors, MPI improves risk prediction of 1-year mortality. This practical prognostic tool may help to optimize management of these vulnerable patients.

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Performance of the Multidimensional Geriatric Assessment and Multidimensional Prognostic Index in predicting negative outcomes in older adults with cancer

Cited by 14 publications

References 38 publications

microRNA in Cardiovascular Aging and Age-Related Cardiovascular Diseases

microRNA in Cardiovascular Aging and Age-Related Cardiovascular Diseases

Comprehensive geriatric assessment in older patients with cancer: an external validation of the Multidimensional Prognostic Index in a French prospective cohort study

Comprehensive geriatric assessment in older patients with cancer: an external validation of the multidimensional prognostic index in a French prospective cohort study

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