Treatment of Subsyndromal Depressive Symptoms in Middle-Age and Older Patients With Schizophrenia: Effect of Age on Response

Purpose To examine the effect of age on the recurrence of soft tissue sarcoma in the extremities and trunk. Patients and Methods This was a multicenter study that included 2,385 patients with median age at surgery of 57 years. The end points considered were local recurrence and metastasis. Cox proportional hazards models were used to estimate hazard ratios across the age ranges with and without adjustment for known confounding factors. Results Older patients presented with tumors that were larger (P < .001) and of higher grade (P < .001). The proportion of positive margins increased significantly as patients age (P < .001), but radiation therapy was relatively underused in patients older than age 60 years. The 5-year cumulative incidences of local recurrence were 7.2% (95% CI, 4% to 11.7%) for patients age 30 years or younger and 12.9% (95% CI, 9.1% to 17.5%) for patients age 75 years or older. The corresponding 5-year cumulative incidences of metastasis were 17.5% (95% CI, 12.1% to 23.7%) and 33.9% (95% CI, 28.1% to 39.8%) for the same groups. Regression models showed that age was significantly associated with local recurrence (P < .001) and metastasis (P < .001) in nonadjusted models. After adjusting for imbalance in presentation and treatment variables, age remained significantly associated with local recurrence (P = .031) and metastasis (P = .019). Conclusion Older patients have worse outcomes because they tend to present with worse tumors and are treated less aggressively. However, there remained a significant increase in the risk of both local and systemic recurrence associated with increasing age that could not be explained by tumor or treatment characteristics.

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Age affects the efficacy of immune checkpoint inhibitors in patients with advanced cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.2638 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 2638-2638

Author(s):

Yongjie Wang ◽

Ronghua Yang ◽

Dong Wang ◽

Donghua Zhao ◽

Peng Li ◽

...

Keyword(s):

Lung Cancer ◽

Advanced Cancer ◽

Immune Checkpoint ◽

Older Patients ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Sign Test ◽

Patients With Cancer ◽

The Impact ◽

Effect Of Age

2638 Background: Immune checkpoint inhibitors (ICIs), such as programmed death(ligand)1 (PD-(L)1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, have dramatic effects on treatment in patients with various malignancies. High tumor mutation burden (TMB) is predictive of clinical response to ICI in multiple cancer types. Although age-related immune dysfunction might induce difference on the efficacy of ICIs between younger and older patients, the potential effect of age on the efficacy of ICIs remains little known and controversial. Herein, we aimed to analysis the association between age and the efficacy of ICIs based on MSKCC cohort. Methods: We screened out 1661 patients having complete information with advanced cancer, whose tumors underwent next-generation sequencing (NGS) detection and who were treated with at least one dose of ICI in MSKCC cohort. All patients were divided into two groups according to age, the younger group (age ≤50-year old) and the older group (age > 50-year old). We further analyzed the differences in overall survival (OS) and TMB between the two groups. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated via Cox regression model for OS and P-values were calculated via the Wilcoxon sign test for TMB. We analyzed the effect of age on ICI in lung cancer using the same way. Results: In 1661 patients with cancer in our study, 312 (19%) younger and 1349 (81%) older patients were found. The pooled HRs for OS was 1.28 (95% CI: 1.09-1.52) in younger group compared with older group. In 1661 patients with cancer, there was 350 (21%) patients with lung cancer, including 30 (9%) younger and 320 (91%) older patients. The pooled HRs for OS was 1.45 (95% CI: 0.95-2.23) in younger group compared with older group in lung cancer. In addition, TMB in older group was higher than in younger group and significant difference of TMB was found via the Wilcoxon sign test (p = 2.6e-10) between the two groups, especially in lung cancer (p = 1e-4). Conclusions: Our study assessed the impact of age on the efficacy of ICIs using the threshold of 50 years old for the first time and we founded that patients in older group had higher TMB and longer OS than younger group.

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Latent Profile Analyses of Depressive Symptoms in Younger and Older Oncology Patients

Assessment ◽

10.1177/1073191118784653 ◽

2018 ◽

Vol 27 (7) ◽

pp. 1383-1398 ◽

Cited By ~ 3

Author(s):

Rebecca M. Saracino ◽

Heining Cham ◽

Barry Rosenfeld ◽

Christian J. Nelson

Keyword(s):

Depressive Symptoms ◽

Older Patients ◽

Latent Profile Analysis ◽

Latent Class ◽

Profile Analysis ◽

Depression Scale ◽

Epidemiological Studies ◽

Class Differences ◽

Patients With Cancer ◽

Latent Profile

The aging of America will include a significant increase in the number of older patients with cancer, many of whom will experience significant depressive symptoms. Although geriatric depression is a well-studied construct, its symptom presentation in the context of cancer is less clear. Latent profile analysis was conducted on depressive symptoms in younger (40-64 years) and older (≥65 years) patients with cancer ( N = 636). The sample was clinically heterogeneous (i.e., included all stages, dominated by advanced stage disease). Participants completed questionnaires including the Center for Epidemiological Studies Depression Scale, which was used for the latent profile analysis. A four-class pattern was supported for each age group. However, the four-class pattern was significantly different between the younger and older groups in terms of the item means within each corresponding latent class; differences were primarily driven by severity such that across classes, older adults endorsed milder symptoms. An unexpected measurement issue was uncovered regarding reverse-coded items, suggesting that they may generate unreliable scores on the Center for Epidemiological Studies Depression Scale for a significant subset of patients. The results indicate that cancer clinicians can expect to see depressive symptoms along a continuum of severity for patients of any age, with less severe symptoms among older patients.

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Effect of age on the performance of a diagnostic strategy based on clinical probability, spiral computed tomography and venous compression ultrasonography

Thrombosis and Haemostasis ◽

10.1160/th04-11-0741 ◽

2005 ◽

Vol 93 (03) ◽

pp. 605-609 ◽

Cited By ~ 9

Author(s):

Francis Couturaud ◽

Florence Parent ◽

Guy Meyer ◽

Philippe Girard ◽

Grégoire Le Gal ◽

...

Keyword(s):

Ct Scan ◽

Older Patients ◽

Age Groups ◽

Spiral Ct ◽

Diagnostic Strategy ◽

Clinical Probability ◽

Venous Compression ◽

Negative Findings ◽

Work Up ◽

Effect Of Age

SummaryAs the prevalence of PE increases with age, the effect of age on the diagnostic work-up in front of a clinical suspicion of PE deserves exploration. In this retrospective analysis, we used the data from 1041 consecutive suspected PE patients. The patients were divided into three groups according to tertiles of age: under 54 years, 54 to 73 years and above 73 years. The prevalence of PE in patients with respectively low, intermediate and high pretest clinical probability was expressed within each age group. We studied the effect of age on the results observed in three main groups of patients, after performing CT scan and ultrasonography (CUS): (1) patients with inconclusive results; (2) patients with negative findings on both exams and non high pretest clinical probability;(3) patients with positive findings. The prevalence of PE increased significantly with age, in overall, as well as in patients with low or intermediate pretest clinical probability. An analysis according to the three main diagnostic groups showed that: (1) the distribution of inconclusive spiral CT or CUS examinations was not different between age groups;(2) no thromboembolic event occurred in untreated patients with low or intermediate clinical probability aged under 54 years of age, whereas 7 events were diagnosed in patients aged over 73 years (p< 0.001); (3) a higher proportion of older patients had a positive result at both spiral CT and CUS examinations. The percentage of positive CT scans in the case of negative or inconclusive CUS results was not different between age groups; conversely, in the case of a negative or inconclusive CT scan, the percentage of positive CUS was higher in older patients. In conclusion, management of elderly suspected PE patients appears to be different from both the work-up and the outcome perspectives.

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