Are computed tomography-based measures of specific abdominal muscle groups predictive of adverse outcomes in older cancer patients?

19673 Background: In order to properly support clinical decisions, geriatric assessment (GA) is recommended for older cancer patients. However, the best form of GA remained unknown and recent studies demonstrated that usual GA tools may have a ceiling effect in detecting adverse outcomes to cancer treatment. Frailty has emerged as a concept characterizing cumulative declines across multiple physiologic systems, leading to increased vulnerability and risk of adverse outcomes. Consequently, the concept of frailty may represent a more sensitive way to better characterize health and functional status and to detect potential vulnerability to adverse outcomes in older cancer patients. The purpose of this pilot study was to explore the usefulness of frailty markers in older cancer patients. Methods: This cross- sectional study included 50 cancer patients, (70 years and older) referred to an oncology clinic for chemotherapy. Chronic diseases, IADL and ADL disabilities, and seven domains considered as frailty markers (nutrition, mobility, strength, energy, physical activities, mood and cognition) were assessed. Patients were classified into hierarchical groups based on the results of their assessment. Results: While 15 (30%) patients had at least one disability in IADL and 8 (16%) patients had at least one disability in ADL, 27 patients (54 %) were completely independent for IADL and ADL. Among those patients with no IADL nor ADL disability, 21 patients (42%) presented at least one frailty marker. In the whole cohort, 44 patients (88%) had at least one frailty markers. The most prevalent of the frailty markers were nutrition, mobility and physical activity (respectively 62%, 58% and 42%). Conclusion: Markers of frailty add substantial information to the usual GA tools in detecting potential vulnerability in older cancer patients. Additional studies are needed to determine if the addition of the frailty markers to the usual GA tools can help to better characterize the older cancer population and predict risk of toxicities and adverse outcomes due to cancer treatment. No significant financial relationships to disclose.

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Computed tomography-assessed loss of muscle mass associates with functional measures in older cancer patients

Journal of Geriatric Oncology ◽

10.1016/s1879-4068(21)00452-5 ◽

2021 ◽

Vol 12 (8) ◽

pp. S61-S62

Author(s):

A. Tolonen ◽

O. Arponen ◽

K. Lehtomäki ◽

P. Osterlund ◽

M. Bärlund ◽

...

Keyword(s):

Computed Tomography ◽

Cancer Patients ◽

Muscle Mass ◽

Functional Measures ◽

Older Cancer Patients

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Systematic Review and Meta-Analysis on the Associations of Polypharmacy and Potentially Inappropriate Medication With Adverse Outcomes in Older Cancer Patients

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa128 ◽

2020 ◽

Author(s):

Li-Ju Chen ◽

Kira Trares ◽

Dana Clarissa Laetsch ◽

Thi Ngoc Mai Nguyen ◽

Hermann Brenner ◽

...

Keyword(s):

Systematic Review ◽

Postoperative Complications ◽

Cancer Patients ◽

Meta Analysis ◽

Inappropriate Medication ◽

Adverse Outcomes ◽

Potentially Inappropriate Medication ◽

Significance Level ◽

All Cause Mortality ◽

Older Cancer Patients

Abstract Background Both polypharmacy and potentially inappropriate medication (PIM) intake are highly prevailing in older cancer patients. However, only studies on the association of polypharmacy and postoperative complications have been meta-analyzed previously. Methods A systematic review and a meta-analysis of prospective/retrospective observational studies reporting associations of polypharmacy or PIM with at least one out of five predefined adverse health outcomes in a population of older cancer patients (≥60 years) were carried out. PubMed and Web of Science were used to search for relevant studies published between January 1991 and March 2020. Data were pooled by adopting a random-effects model. Results Overall, 42 publications were included in the systematic review. Meta-analyses could be performed on 39 studies about polypharmacy and 13 studies about PIM. Polypharmacy was found to be statistically significantly associated with all-cause mortality (risk ratio [95% confidence interval]: 1.37 [1.25–1.50]), hospitalization (1.53 [1.37–1.71]), treatment-related toxicity (1.22 [1.01–1.47]), and postoperative complications (1.73 [1.36–2.20]). The association of polypharmacy with prolongation of hospitalization was not statistically significant at the p < .05 significance level (1.62 [0.98–2.66]). With respect to PIM, a statistically significant association with all-cause mortality (1.43 [1.08–1.88]) was observed but not with other adverse outcomes. Conclusions Polypharmacy was found to be associated with several adverse outcomes and PIM use with all-cause mortality in older cancer patients. However, these results should be interpreted with caution because about three-quarters of the studies identified did not adjust for comorbidity and are prone to confounding by indication.

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