237 Selected global health assessment tools significantly predict postoperative clinical outcome in elderly patients with ovarian cancer

Background: We evaluated the prognostic impact of various global health assessment tools in patients older than 60 years with ovarian cancer (OC). Methods: G-8 geriatric screening tool (G-8 score), Lee Schonberg prognostic index, Eastern Cooperative Oncology Group (ECOG) performance status, and Charlson Comorbidity Index (CCI) were determined retrospectively in a consecutive cohort of elderly patients with OC. Univariate and multivariate Cox regression analyses and Kaplan-Meier method were performed to analyze the impact of the preoperative global health status on survival. Results: 116 patients entered the study. In multivariate analysis adjusted for clinical-pathological factors, only the G-8 score retained significance as a prognostic parameter of progression-free survival (PFS) (hazard ratio [HR]: 1.970; 95% confidence interval [CI] [1.056–3.677]; p = 0.033). Fifty-six patients were classified as G-8-nonfrail with an increased PFS compared to 50 G-8-frail patients (53.4% vs. 16.7%; p = 0.010). A higher CCI was associated with decreased PFS (45.1% vs. 22.2%; p = 0.012), but it did not influence the risk of recurrences or death (p = 0.360; p = 0.111). The Lee Schonberg prognostic index, the ECOG, and age were not associated with survival. Conclusions: The G-8 score independently predicted PFS in elderly OC patients regardless of maximal surgical effort. Thus, it could be useful to assess surgical treatment based on frailty rather than age alone.

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Health and Fall Risk Monitoring Within Common Assessments

Integrated Care and Fall Prevention in Active and Healthy Aging - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-7998-4411-2.ch010 ◽

2021 ◽

pp. 182-199

Author(s):

Rafael Nogueira Rodrigues ◽

Adriana Caldo ◽

Fernanda M. Silva ◽

Cidalina Conceição Ferreira Abreu ◽

Guilherme Eustaquio Furtado ◽

...

Keyword(s):

Global Health ◽

Fall Risk ◽

Health Assessment ◽

Assessment Tools ◽

Specific Intervention ◽

Common Assessments ◽

Risk Monitoring ◽

Fitness Assessment ◽

Assessment And Monitoring ◽

Specific Assessment

This chapter presents an exploratory review on the evaluation, assessment, and monitoring in health and fall risk by common and the most used assessment tools. The main discussion of this chapter of evaluation in health and fall risk is divided into six categories—global health assessment, specific physical (and fitness) assessment, cognitive and psychological assessment, pharmacological assessment, fall risk specific assessment, and some complementary assessment—which show information and how to access. Whereas health evaluative experiences and practices are essential to drive a better and specific intervention, revealing its importance and necessity was also highlighted.

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Neoadjuvant chemotherapy in high-risk ovarian cancer patients: Role of age

Tumori Journal ◽

10.1177/0300891618792468 ◽

2018 ◽

Vol 105 (2) ◽

pp. 168-173 ◽

Cited By ~ 1

Author(s):

Raffaella Cioffi ◽

Alice Bergamini ◽

Emanuela Rabaiotti ◽

Micaela Petrone ◽

Francesca Pella ◽

...

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Elderly Patients ◽

Residual Disease ◽

Performance Status ◽

Assessment Tools ◽

Advanced Age ◽

Poor Performance Status ◽

Group A

Objective: To review a single-center clinical experience with neoadjuvant chemotherapy (NACT) in a population of frail epithelial ovarian cancer (EOC) patients and investigate the prognostic role of advanced age. Methods: We retrospectively reviewed clinical data from 102 advanced EOC patients treated with NACT and presenting high perioperative risk. Patients were divided into 2 groups: group A, including patients aged 70 years or older; and group B, including patients below 70 years old. Univariate and multivariate analyses were performed to compare survival and prognostic factors for survival between the two groups. Results: Forty-two patients (41.2%) were older than 70 years. Elderly patients were more likely to present comorbidities ( p = 0.0001), poor performance status ( p = 0.04), and multiple indications for NACT ( p = 0.03). They showed a reduced response to NACT, since only 64% of elderly patients underwent surgical debulking (98.3% vs 64.3%, p = 0.001) and, among these, half of them were optimally debulked (79.3% vs 50%, p = 0.01). Median progression-free survival (PFS) and overall survival (OS) were significantly lower in group A (respectively, 9 vs 13 months, p = 0.005, and 21 vs 29 months, p = 0.01). Advanced age, IV stage, presence of ascites, and residual disease >1 cm were significantly associated with a lower PFS. However, when analyzing factors associated with OS, the only significant ones were higher American Society of Anesthesiologists score and residual disease >1 cm. Conclusions: Age was not found to be a prognostic factor for survival. This highlights the necessity of validated geriatric assessment tools predicting functional age and treatment tolerability to avoid undertreatment of elderly patients.

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