scholarly journals Comprehensive geriatric assessment in older patients with cancer: an external validation of the Multidimensional Prognostic Index in a French prospective cohort study

2019 ◽  
Author(s):  
Chunyun Hu ◽  
Marc Paccalin ◽  
Simon Valero ◽  
Amelie Jamet ◽  
Thomas Brunet ◽  
...  
Keyword(s):  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
External Validation ◽  
Prognostic Index ◽  
Risk Groups ◽  
University Hospital ◽  
Patients With Cancer ◽  
Cox Proportional Hazard Regression ◽  
One Year

Abstract Background: Older patients with cancer require specific and individualized management. The Multidimensional Prognostic Index (MPI) based on the Comprehensive Geriatric Assessment (CGA) has shown a predictive interest in terms of mortality.Methods: From 2015 to 2017, consecutive patients ≥75 years old with cancer in Poitiers University Hospital referred to an oncogeriatric consultation. Patients underwent CGA with MPI that is categorized into three risk groups of mortality at one year.Results: Overall, 433 patients were included (women 42%; mean age 82.8±4.8 years). Most common tumor sites were prostate (23%), skin (17%), colorectum (15%) and breast (12%); 29% patients had a metastatic disease; 231 patients (53%) belonged to "MPI-1" group, 172 (40%) to "MPI-2" group and 30 patients (7%) were classified in "MPI-3" group. One-year mortality rate was 32% (23% in MPI-1, 41% in MPI-2 and 53% in MPI-3, p=0.024). All domains of MPI except cognition and living status were significantly associated with mortality at one-year, as well as tumor sites and metastatic status. Cox proportional hazard regression analysis, adjusted on age, gender, tumor sites and metastatic status, validated MPI as being associated with a higher mortality risk (p<0.0001). The prognostic value of MPI was confirmed by the area under the ROC curve at 0.826 (P <0.0001).Conclusion: Our study confirmed the predictive value of MPI for one-year mortality in older patients with cancer. This practical prognostic tool may help to optimize the management of these vulnerable patients.

scholarly journals Development and Validation of a Multidimensional Prognostic Index for One-Year Mortality from Comprehensive Geriatric Assessment in Hospitalized Older Patients

2008 ◽  
Vol 11 (1) ◽  
pp. 151-161 ◽  
Author(s):  
Alberto Pilotto ◽  
Luigi Ferrucci ◽  
Marilisa Franceschi ◽  
Luigi P. D'Ambrosio ◽  
Carlo Scarcelli ◽  
...  
Keyword(s):  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
Prognostic Index ◽  
One Year ◽  
Development And Validation

Comprehensive Geriatric Assessment for Older Patients With Cancer

2007 ◽  
Vol 25 (14) ◽  
pp. 1824-1831 ◽  
Author(s):  
Martine Extermann ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Cancer Care ◽  
Older Patients ◽  
Morbidity And Mortality ◽  
Psychological State ◽  
Future Research ◽  
Oncology Patient ◽  
Patients With Cancer

Purpose During the last decade, oncologists and geriatricians have begun to work together to integrate the principles of geriatrics into oncology care. The increasing use of a comprehensive geriatric assessment (CGA) is one example of this effort. A CGA includes an evaluation of an older individual's functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support; and a review of the patient's medications. This article discusses recent advances on the use of a CGA in older patients with cancer. Methods In this article, we provide an update on the studies that address the domains of a geriatric assessment applied to the oncology patient, review the results of the first studies evaluating the use of a CGA in developing interventions to improve the care of older adults with cancer, and discuss future research directions. Results The evidence from recent studies demonstrates that a CGA can predict morbidity and mortality in older patients with cancer. Accumulating data show the benefits of incorporating a CGA in the evaluation of older patients with cancer. Prospective trials evaluating the utility of a CGA to guide interventions to improve the quality of cancer care in older adults are justified. Conclusion Growing evidence demonstrates that the variables examined in a CGA can predict morbidity and mortality in older patients with cancer, and uncover problems relevant to cancer care that would otherwise go unrecognized.

scholarly journals Predicting outcome in older patients with cancer: Comprehensive geriatric assessment and clinical judgment

2021 ◽  
Vol 12 (1) ◽  
pp. 49-56
Author(s):  
Kathelijn S. Versteeg ◽  
Stéphanie M.L.M. Looijaard ◽  
Monique S. Slee-Valentijn ◽  
Henk M.W. Verheul ◽  
Andrea B. Maier ◽  
...  
Keyword(s):  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Clinical Judgment ◽  
Older Patients ◽  
Patients With Cancer ◽  
Predicting Outcome

Multidimensional geriatric evaluation in elderly cancer patients and its relationship with age

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19651-19651
Author(s):  
M. Molina-Garrido ◽  
C. Guillén-Ponce ◽  
A. Carrato
Keyword(s):  
Health Status ◽  
Activities Of Daily Living ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
Older Patients ◽  
Patients With Cancer ◽  
Medication Intake ◽  
Oncologic Patients

19651 Background: Age is the major risk factor for the majority of patients with cancer. More than 50% of cancers occurs after the age of 60. Older patients are not simply old, but are geriatric patients because of interacting psychosocial and physical problems. As a consequence, the health status of old persons cannot be evaluated by merely describing the single disease or the group of age. We tested the performance of a new Comprehensive Geriatric Assessment (CGA) and its relationship with groups of age in cancer patients. Methods: Between June 2006 and December 2006, a total of 64 oncologic patients older than 75 years were approached to enrol in our study to analyze their functional, physical, mental, pharmacotherapeutic and socio-economic status and to correlate them to some groups of age: youngest-old (75 to 80 years-old), old-old (80 and 85 years-old) and oldest-old (older than 85 years). They were analysed Activities of Daily Living (ADL) measured by Barthel Scale, Instrumental Activities of Daily Living (IADL) measured by Lawton-Brody Scale, Grade of Fragility measured by Barber Scale, cognitive evaluation measured by Pfeiffer Test, and medication intake. A Chi Squared test was used for statistical analysis; p-value <0,05 was considered significative. Results: Sixty-four oncologic patients age > or = 75 years were recruited. Median age was 80.24 years (range 73.88 to 86.94). 51.6% female. Breast cancer was the most frequent diagnosis (30.2%), followed by lung cancer (19%). 29 patients (45.3%) were aged between 75 and 80 years old; 27 patients (43.5%) were between 80 and 85 years- old. There were statistic significative association between groups of age and Pfeiffer Test (p=0.037), Barber Scale (p=0.031) and medication intake (p=0.021). However, there was not a significative relationship between groups of age and Barthel Scale (p=0.052), Lawton-Brody Scale (p=0.2425), Cruz-Roja Scale (p=0,1485) or number of geriatric syndromes (p=0.129). Conclusions: This abstract reviews the findings regarding the correlation between a comprehensive geriatric assessment (CGA) and groups of age in older patients with cancer. Age per se must not be the only criterion for medical decision as it is not correlated to the health status of older cancer patients. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document