The Value of Geriatric Assessments in Predicting Treatment Tolerance and All-Cause Mortality in Older Patients With Cancer

Hamaker, Marije E.; Vos, Antonie; Smorenburg, Carolien H.; Rooij, Sophia E. de; Munster, Barbara C. Van

doi:10.1634/theoncologist.2012-0186

Cited by 151 publications

(107 citation statements)

References 90 publications

(48 reference statements)

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“…In our study, these were comorbidity, functional status, and nutritional status. However, the evidence regarding the predictive value of individual domains of the GA is still inconsistent [16]. In addition, some domains have obvious clinical value irrespective of predictive power.…”

Section: Discussionmentioning

confidence: 99%

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Frailty Is an Independent Predictor of Survival in Older Patients With Colorectal Cancer

et al. 2014

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Background. Colorectal cancer (CRC) is prevalent in the older population. Geriatric assessment (GA) has previously been found to predict treatment tolerance and postoperative complications in older cancer patients. The aim of this study was to explore whether GA also predicts 1-year and 5-year survival after CRC surgery in older patients and to compare the predictive power of GA with that of established prognostic factors such as TNM classification of malignant tumors (TNM) stage and age. Materials and Methods. A cohort of 178 CRC patients aged 70 and older were followed prospectively. All patients went through elective surgery, and GA was performed presurgery. The GA resulted in patients being divided into two groups: frail or nonfrail. All patients were followed for 5 years or until death. Data were analyzed by Kaplan-Meier plots and the Cox proportional hazards model.

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Section: Discussionmentioning

confidence: 99%

“…However, two recent reviews conclude that the evidence is still conflicting and that further research is needed to establish the role of GA in predicting outcomes and affecting treatment decisions [16,17].…”

Section: Introductionmentioning

confidence: 99%

Frailty Is an Independent Predictor of Survival in Older Patients With Colorectal Cancer

et al. 2014

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“…However, various geriatric conditions appear to be of some value in predicting outcome in older adult patients with cancer [12]. One instrument that is often suggested as useful for obtaining a thorough overview of patients' health by determining the functional, cognitive and psychosocial status in addition to comorbidity, medication use and nutritional status, is the geriatric assessment [13,14].…”

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confidence: 99%

Physical performance measures for predicting outcome in cancer patients: a systematic review

et al. 2016

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Background: Decision making regarding cancer treatment is challenging and there is a need for clinical parameters that can guide these decisions. As physical performance appears to be a reflection of health status, the aim of this systematic review is to assess whether physical performance tests (PPTs) are predictive of the clinical outcome and treatment tolerance in cancer patients. Methods: A literature search was conducted on 2 April 2015 in the electronic databases Medline and Embase to identify studies focusing on the association between objectively measured PPTs and outcome. No limitations in language or publication dates were applied. Results: The search retrieved 9680 articles, 16 publications were included involving 4187 patients with various cancer types and different treatments. Reported median or mean age varied from 58 to 78 years. Nine studies used the Timed Up & Go (TUG) test, five the Short Physical Performance Battery (SPPB) and five studies focused on gait speed. Poorer TUG, SPPB and gait speed outcome were associated with decreased survival. TUG, SPPB and gait speed were also associated with treatment-related complications. Furthermore, two studies reported an association between poorer TUG and SPPB outcome with higher rates of functional decline. Conclusion: PPTs appear to show a significant correlation with survival and these tests could be used as a prognostic tool, particular for older adult patients. A less explicit correlation for treatment-related complications and functional decline was also found. To optimize decision making, future research should focus on developing and validating individualized treatment algorithms that incorporate PPTs in addition to cancer-and treatment-related variables.

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“…Low grip strength was reported to be the only frailty marker (of seven measured) to predict treatment toxicity in a prospective observational study of 112 patients with different types of cancer [26]. Hamaker et al [27] conducted a systematic search of studies on geriatric assessment in oncology, focusing on the association between baseline assessment and outcomes, and found that frailty was predictive of chemotherapy-induced toxicity; impairments in cognitive functions and activities of daily living were predictive of chemotherapy completion, and impairment in instrumental activities of daily living was predictive of perioperative complications. However, these results were too inconsistent to guide treatment decisions.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience

Rivoirard¹,

Chargari

Kullab³

et al. 2015

Chemotherapy

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Background: The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized. Methods: In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment. Results: Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years. Conclusion: Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life.

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The Value of Geriatric Assessments in Predicting Treatment Tolerance and All-Cause Mortality in Older Patients With Cancer

Cited by 151 publications

References 90 publications

Frailty Is an Independent Predictor of Survival in Older Patients With Colorectal Cancer

Frailty Is an Independent Predictor of Survival in Older Patients With Colorectal Cancer

Physical performance measures for predicting outcome in cancer patients: a systematic review

Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience

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