The role of Geriatric screening tool (G8) in predicting side effect in older patients during therapy with aromatase inhibitor

Dottorini, Lorenzo; Catena, Laura; Sarno, Italo; Menna, Grazia; Marte, Annamaria; Novelli, Eugenio; Rusca, Carmen; Bajetta, Emilio

doi:10.1016/j.jgo.2018.10.007

Cited by 16 publications

(19 citation statements)

References 10 publications

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“…The primary study was conducted within the University of Rochester Cancer Center National Cancer Institute Community Oncology Program Research Network and enrolled patients who were aged 70 years and above, had a diagnosis of an incurable stage III/IV solid tumor or lymphoma, had at least one impaired GA domain, and were considering or receiving any kind of cancer treatment. GA assesses age‐related vulnerabilities or domains that are predictive of morbidity and mortality in older adults with cancer . In our study, GA domains were assessed using validated tools and cutoffs and included comorbidity , functional status , physical performance , cognition , instrumental social support (e.g., someone to help if you were confined to bed) , polypharmacy , psychological health , and nutrition (supplemental online Table 1).…”

Section: Methodsmentioning

confidence: 99%

Beliefs About Advanced Cancer Curability in Older Patients, Their Caregivers, and Oncologists

et al. 2019

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Background Ensuring older patients with advanced cancer and their oncologists have similar beliefs about curability is important. We investigated discordance in beliefs about curability in patient‐oncologist and caregiver‐oncologist dyads. Materials and Methods We used baseline data from a cluster randomized trial assessing whether geriatric assessment improves communication and quality of life in older patients with advanced cancer and their caregivers. Patients were aged ≥70 years with incurable cancer from community oncology practices. Patients, caregivers, and oncologists were asked: “What do you believe are the chances the cancer will go away and never come back with treatment?” Options were 100%, >50%, 50/50, <50%, and 0% (5‐point scale). Discordance in beliefs about curability was defined as any difference in scale scores (≥3 points were severe). We used multivariate logistic regressions to describe correlates of discordance. Results Discordance was present in 60% (15% severe) of the 336 patient‐oncologist dyads and 52% (16% severe) of the 245 caregiver‐oncologist dyads. Discordance was less common in patient‐oncologist dyads when oncologists practiced longer (adjusted odds ratio [AOR] 0.90, 95% confidence interval [CI] 0.84–0.97) and more common in non‐Hispanic white patients (AOR 5.77, CI 1.90–17.50) and when patients had lung (AOR 1.95, CI 1.29–2.94) or gastrointestinal (AOR 1.55, CI 1.09–2.21) compared with breast cancer. Severe discordance was more common when patients were non‐Hispanic white, had lower income, and had impaired social support. Caregiver‐oncologist discordance was more common when caregivers were non‐Hispanic white (AOR 3.32, CI 1.01–10.94) and reported lower physical health (AOR 0.88, CI 0.78–1.00). Severe discordance was more common when caregivers had lower income and lower anxiety level. Conclusion Discordance in beliefs about curability is common, occasionally severe, and correlated with patient, caregiver, and oncologist characteristics. Implications for Practice Ensuring older patients with advanced cancer and their caregivers have similar beliefs about curability as the oncologist is important. This study investigated discordance in beliefs about curability in patient‐oncologist (PO) and caregiver‐oncologist (CO) dyads. It found that discordance was present in 60% (15% severe) of PO dyads and 52% (16% severe) of CO dyads, raising serious questions about the process by which patients consent to treatment. This study supports the need for interventions targeted at the oncologist, patient, caregiver, and societal levels to improve the delivery of prognostic information and patients’/caregivers’ understanding and acceptance of prognosis.

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Section: Methodsmentioning

confidence: 99%

Beliefs About Advanced Cancer Curability in Older Patients, Their Caregivers, and Oncologists

et al. 2019

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“…Many studies have been conducted in other medical fields, including various oncology populations, indicating a strong association between frailty and adverse health outcomes after treatment. 48,56,72 However, the association of frailty with complications and mortality seen in previous studies might not be applicable to dermato-oncology. Therefore, more research on the consequences of frailty for dermatological oncology patients is needed.…”

Section: Tablementioning

confidence: 97%

“…[19][20][21][22]45 The G8 and mG8 can be performed within 5 min; the GFI and SAOP2 can be completed in 10 min. 4,6,10,48,49 All four FSTs have clear cut-off points to identify frail patients in need of more extensive geriatric evaluation. No studies were available on the suitability of the (m)G8, GFI and SAOP2 for low-literate or low-educated patients, nor on the clinical relevance and impact of the outcomes in daily dermato-oncology practice.…”

Section: Systematic Literature Search and Fst Selectionmentioning

confidence: 99%

“…Content-related domains of each frailty screening tool (FST) as identified by the systematic literature search Frailty screening in dermato-oncology extensively studied tool with appropriate measurement properties when compared to a full GA. [10][11][12][13]19,48,[50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] In the few articles studying the recently developed mG8, sensitivity (89-92%) and specificity (36-79%) for geriatric impairments detected by GA appear higher than the original G8. 20,61 However, the mG8 is currently only available in a limited number of languages.…”

Section: Tablementioning

confidence: 99%

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Frailty screening in dermato‐oncology practice: a modified Delphi study and a systematic review of the literature

Winden

Garcovich

Peris

et al. 2020

Acad Dermatol Venereol

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Background Appropriate management and prevention of both under-and overtreatment in older skin cancer patients can be challenging. It could be helpful to incorporate frailty screening in dermato-oncology care, since frailty is associated with adverse health outcomes. Objectives This study aimed to identify and prioritize the requirements a frailty screening tool (FST) should fulfil in dermato-oncology practice and to select the best existing FST(s) for this purpose. Methods A modified two-round Delphi procedure was performed among 50 Italian and Dutch specialists and patients to review and prioritize a list of potential FST requirements, using a 5-point Likert scale. Consensus was defined as a mean score of ≥4.0. A systematic literature search was performed to identify existing multidomain FSTs, which were then assessed on the requirements resulting from the modified Delphi procedure. Results Consensus was achieved on evaluation of comorbidities (4.3 AE 0.7), polypharmacy (4.0 AE 0.9) and cognition (4.1 AE 0.8). The FST should have appropriate measurement properties (4.0 AE 1.0), be quickly executed (4.2 AE 0.7), clinically relevant (4.3 AE 0.7), and both easily understandable (4.1 AE 1.2) and interpretable (4.3 AE 0.7). Of the 26 identified FSTs, four evaluated the content-related domains: the Geriatric-8 (G8), the modified Geriatric-8 (mG8), the Groningen Frailty Indicator (GFI) and the Senior Adult Oncology Program 2 (SAOP2) screening tool. Of these, the G8 was the most extensively studied FST, with the best psychometric properties and execution within 5 min. Conclusions The G8 appears the most suitable FST for assessing frailty in older adults with skin cancer, although clinical studies assessing its use in a dermato-oncology population are needed to further assess whether or not frailty in this particular patient group is associated with relevant outcomes (e.g. complications and mortality), as seen in previous studies in other medical fields.

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“…Clinical trials demonstrated that G8 is strongly prognostic for functional decline on ADLs/IADLs and overall survival [45]. Furthermore, an association with early mortality [46] and a potential role in predicting side effects even in non-chemotherapy treatments have been demonstrated [47]. VES-13 is a scale containing 13 questions considering age, self-assessment of health and possible difficulties in performing functional and physical activities [48].…”

Section: The Oncological Point Of Viewmentioning

confidence: 99%

Definition and assessment of frailty in older patients: the surgical, anaesthesiological and oncological perspective

Dottorini¹,

Turati²,

Mattei³

et al. 2020

ecancer

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The number of oncology, surgery and anaesthesia procedures in older patients has greatly increased in recent years due to ageing populations. Older patients are typically characterised by physical changes such as comorbidities, decline in physiological activities and cognitive impairment. All these factors, together with polypharmacological therapies, may substantially impact perioperative outcome, quality of recovery and, more in general, quality of life. A comprehensive multidisciplinary approach to perioperative care is thus needed. The assessment of frailty has a central role in the pre-operative evaluation of older patients and, with a multidisciplinary approach. The best surgical procedures and oncologic therapies can be accurately discussed in the pre-and post-operative periods. All clinicians involved in this scenario should be proactive in multidisciplinary care to achieve better outcomes.

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The role of Geriatric screening tool (G8) in predicting side effect in older patients during therapy with aromatase inhibitor

Cited by 16 publications

References 10 publications

Beliefs About Advanced Cancer Curability in Older Patients, Their Caregivers, and Oncologists

Beliefs About Advanced Cancer Curability in Older Patients, Their Caregivers, and Oncologists

Frailty screening in dermato‐oncology practice: a modified Delphi study and a systematic review of the literature

Definition and assessment of frailty in older patients: the surgical, anaesthesiological and oncological perspective

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