A mini geriatric assessment helps treatment decision in elderly patients with digestive cancer. A pilot study

2011 ◽  
Vol 77 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Thomas Aparicio ◽  
Laurence Girard ◽  
Nadia Bouarioua ◽  
Claire Patry ◽  
Sylvie Legrain ◽  
...  
Blood ◽  
2017 ◽  
Vol 130 (20) ◽  
pp. 2180-2185 ◽  
Author(s):  
Richard J. Lin ◽  
Madhusmita Behera ◽  
Catherine S. Diefenbach ◽  
Christopher R. Flowers

Abstract Survival outcome for elderly patients with newly diagnosed diffuse large B-cell lymphoma remains suboptimal in the rituximab era. In this systematic review, we summarize available evidence relevant to the inclusion of anthracycline in upfront chemoimmunotherapy for these elderly patients and highlight the need of prospective clinical trials. With limited prospective data, we find that pretreatment comprehensive geriatric assessment accurately predicts survival and treatment-related toxicities, suggesting its potential role in guiding overall treatment decision-making.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 115-115
Author(s):  
Hina Niranjan Mehta ◽  
Rania Farhat ◽  
Sravanthi Ravulapati ◽  
Yifan Tu

115 Background: The elderly population is the fastest growing segment of the US population, and it is widely affected by cancer and its related sequelae. At St. Louis University (SLU), a simple Rapid Geriatric Assessment (RGA) was developed based on the SLU Mental Status Exam (SLUMS). The RGA includes screening for frailty, sarcopenia, nutrition, and cognition. In this pilot study, we used RGA to assess geriatric patients with newly diagnosed malignancy prior to cancer therapy and its ability to improve outcomes in oncology patients. Methods: Elderly patients (aged 65 and above) with newly diagnosed malignancy completed the RGA either inpatient or outpatient at SLU. A retrospective chart review was done to collect patient's demographics, type of malignancy, number of hospitalizations since diagnosis and referral to palliative care over a 6 month period. Relationship between tolerability and RGA subscores were assessed using general linear models, Kaplan-Meier survival analysis and Chi-square testing. Results: Twenty six patients (mean age 76 [65-90]) were included from December 2015 to 2016 of which 9 were male (n = 35) and 17 female (n = 65). 19 patients (73%) were inpatient, 7 (27%) were outpatient and 13 patients (50%) received chemotherapy. Using the Mann-Whitney U test, no significant difference was seen between RGA subscores (FRAIL p = 1; SNAQ p = 0.69; SARC-F p = 0.71; RCS p = 1) in patients receiving versus not receiving chemotherapy. There was no significant difference in overall survival (OS) over a 20 month period based on chemotherapy status (p = 0.39). In our study, 62% of patients (n = 16) were referred to palliative care and noted to have a significant better OS (p = 0.04). Conclusions: The RGA is a self-explanatory tool that can be used in geriatric oncology patients and it can bedone in 10 minutes. In this pilot study, we used this tool in a small number of patients. We plan to perform a prospective study to evaluate the RGA comparing to ECOG-performance status in geriatric patients prior to standard cancer therapies. Improvement of overall survival with incorporation of palliative care in oncology patients is reaffirmed in our study.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19667-19667
Author(s):  
T. Cudennec ◽  
E. Mitry ◽  
S. Moulias ◽  
C. Lepere ◽  
A. Lievre ◽  
...  

19667 Background: A standardized geriatric evaluation is essential for the multidisciplinary discussion of elderly patients with gastrointestinal cancer. A geriatric as well as an oncological evaluation are mandatory to offer to these patients the best therapeutic option and improve their prognosis as well as their quality of life. A Geriatric Intervention Team (GIT) composed by nurses and geriatrician is working in our hospital. One of its function is to evaluate elderly patients with digestive neoplasms in collaboration with the Digestive Oncology unit (DOU). Methods: The Mini Mental State Examination, the mini-Geriatric Depression Scale and the Get up and go timed test were used for the geriatric evaluation. Results: GIT was solicited for 124 pts over a 3-year period. Their mean age was 79,1 ± 6,3 years old (65 to 96), 45% were men. The neoplasic localizations were: colorectal (53%), pancreatic (17%), esophagus (11%), hepatic carcinoma (7%) and other (12%). There was a clear prevalence of cognitive disorders identified by the Folstein MMSE. Among 65 workable files (complete MMSE), 61% of the patients had an abnormal (< 26). The observation of a time and/or space disorientation was noticed in 30% of the cases. The mini-GDS used to detect depression, was positive in 43% of the evaluations. The Timed Get Up and Go Test was used to evaluate the walking capacity self-sufficiency and the risk of falls. It was superior to 20 seconds in 40% of cases. For 77 geriatrics evaluation, the GIT was solicited before the decision of the best treatment to choose. In this population, we can clearly identify 3 clusters of patients: well-matched patients (34%) who received chimiotherapy; intermediate patients (26%) who needed a new geriatric assessment before decision; and frailed patients (40%) who received only palliative treatment. In the second group, after geriatrician intervention, 60% of patients finally received a chemotherapy. Conclusions: These results show the benefit of a close collaboration between geriatricians and oncologist. In the daily management of elderly patients, alteration are at least detected in 55% of patients by geriatric assessment. Moreover, the GIT is allow to securely classify the patients between the 3 categories and help to decision in the intermediate group. No significant financial relationships to disclose.


2010 ◽  
Vol 24 (7) ◽  
pp. 614-622 ◽  
Author(s):  
JJ Dronkers ◽  
H. Lamberts ◽  
IMMD Reutelingsperger ◽  
RH Naber ◽  
CM Dronkers-Landman ◽  
...  

2011 ◽  
Vol 20 (2) ◽  
pp. 135-138 ◽  
Author(s):  
Olga Kharevich ◽  
Barry Shipman ◽  
Barry M. Goldman ◽  
Max Nahon
Keyword(s):  

Sign in / Sign up

Export Citation Format

Share Document