scholarly journals Prognosis of outcomes of surgical treatment of colorectal cancer among older patients

2019 ◽  
Vol 3 (28) ◽  
pp. 26-32
Author(s):  
D. A. Kochanov ◽  
M. D. Ter-Ovanesov ◽  
A. S. Gaboyan ◽  
M. Yu. Kukosh
Keyword(s):  
Colorectal Cancer ◽  
Older Adults ◽  
Surgical Treatment ◽  
Cancer Therapy ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
Improved Outcomes ◽  
Number Of Patients

The percentage of older adults with colorectal cancer has been increased. It is a worldwide trend. We proved a necessity of using special predictive scales Charlson, CR-POSSUM, ACPGBI and use of Comprehensive geriatric assessment (CGA) as a part of preoperation eximination among older adults. This approach is improved outcomes of surgical treatment and increased the number of patients undergoing radical cancer therapy.

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 Nutrition in Cancer Therapy in the Elderly—An Epigenetic Connection?

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3366
Author(s):  
Janusz Blasiak ◽  
Jan Chojnacki ◽  
Elzbieta Pawlowska ◽  
Joanna Szczepanska ◽  
Cezary Chojnacki
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Cancer Therapy ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
The Elderly ◽  
Assessment Tools ◽  
Continuous Increase ◽  
Epigenetic Profile

The continuous increase in life expectancy results in a steady increase of cancer risk, which consequently increases the population of older adults with cancer. Older adults have their age-related nutritional needs and often suffer from comorbidities that may affect cancer therapy. They frequently are malnourished and present advanced-stage cancer. Therefore, this group of patients requires a special multidisciplinary approach to optimize their therapy and increase quality of life impaired by aging, cancer, and the side effects of therapy. Evaluation strategies, taking advantage of comprehensive geriatric assessment tools, including the comprehensive geriatric assessment (CGA), can help individualize treatment. As epigenetics, an emerging element of the regulation of gene expression, is involved in both aging and cancer and the epigenetic profile can be modulated by the diet, it seems to be a candidate to assist with planning a nutritional intervention in elderly populations with cancer. In this review, we present problems associated with the diet and nutrition in the elderly undergoing active cancer therapy and provide some information on epigenetic aspects of aging and cancer transformation. Nutritional interventions modulating the epigenetic profile, including caloric restriction and basal diet with modifications (elimination diet, supplementary diet) are discussed as the ways to improve the efficacy of cancer therapy and maintain the quality of life of older adults with cancer.

Predictive Ability of the G8 Screening Test to Determine Probable Sarcopenia and Abnormal Comprehensive Geriatric Assessment in Older Patients with Solid Malignancies

2021 ◽  
Author(s):  
Cagatay Cavusoglu ◽  
Gozde Tahtaci ◽  
Rana Tuna Dogrul ◽  
Ibrahim Ileri ◽  
Funda Yildirim ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Screening Test ◽  
Older Patients ◽  
Screening Tool ◽  
Handgrip Strength ◽  
Predictive Ability ◽  
Solid Malignancies

Abstract Background: Pre-treatment evaluation for sarcopenia is recommended in cancer patients. We aimed to investigate whether the G8 screening test can detect probable sarcopenia and is valid and reliable compared to comprehensive geriatric assessment (CGA) in Turkish older adults with solid cancers.Methods: We included solid cancer patients referred to a single center. Probable sarcopenia and abnormal CGA were defined as low handgrip strength and impairment in at least one of the CGA tests, respectively. Receiver operating characteristic curve analyses evaluated the test’s predictive ability. Intra-rater and inter-rater reliabilities were assessed.Results: The median age of the 76 patients included was 72 (65–91) years. There was a moderate correlation between handgrip strength and the G8 test total score. The sensitivity and specificity of the G8 test to detect probable sarcopenia alone were 50% and 92%, respectively (area under the curve [AUC]: 0.747; p<0.001); to determine abnormal CGA plus probable sarcopenia were 93.33% and 86.89%, respectively (AUC: 0.939; p<0.001), and to detect abnormal CGA alone were 79.63% and 95.45%, respectively (AUC: 0.893; p<0.001). The G8 test results agreed with those of CGA (κ=0.638; p<0.001). Both inter- and intra-rater assessments of G8 scores revealed a strong agreement (Interclass correlation coefficient (ICC)=0.979, p<0.001 and ρ=0.994, p<0.001, respectively). Conclusions: The Turkish version of the G8 test is a good screening tool to detect probable sarcopenia alone and in conjunction with abnormal CGA in older patients with solid malignancies. The G8 screening tool may be useful in detecting probable sarcopenia in Turkish older adults with solid cancers.

scholarly journals Do The Oncologists Systematically Follow Treatment Recommendations And Protocol Adaptations Suggested By Prior Comprehensive Geriatric Assessment In Older Patients With Colorectal Cancer?

2020 ◽  
Vol 6 (6) ◽  
pp. 1-12
Author(s):  
Frédérique Retornaz ◽  
Keyword(s):  
Colorectal Cancer ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
Treatment Recommendations ◽  
Therapeutic Decision ◽  
Older Patient ◽  
To Receive

In order to assess the ability of older patient with Colorectal Cancer (CRC) to receive chemotherapy, a Comprehensive Geriatric Assessment (CGA) is recommended before the final therapeutic decision.

scholarly journals 52 Should Physiotherapists and Occupational Therapists be Part of the Comprehensive Geriatric Assessment Clinics within the Outpatient Setting?

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Alexandra Denning-Kemp ◽  
Hannah Melville ◽  
Teresa Meldrum ◽  
Carrie-Ann Wood
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Outpatient Setting ◽  
Initial Assessment ◽  
Timed Up And Go ◽  
Complex Needs ◽  
Therapy Assessment ◽  
Number Of Patients ◽  
Therapy Intervention

Abstract Introduction The British Geriatric Society (2015) recommends a multidisciplinary team (MDT) Comprehensive Geriatric Assessment (CGA) framework as the Gold standard of care for frail older adults with complex needs. There are currently five Consultant and Nurse-led outpatient CGA clinics in the Older Persons’ Assessment Unit (OPAU), which refer into Physiotherapy (PT) and Occupational Therapy (OT) following their assessments. The aim was to improve the care of patients across the CGA pathway by auditing to establish whether therapists should be involved in the initial assessment of patients in these clinics. Of all new CGA patients in a six month period, only 8% and 2% were referred to PT and OT respectively, warranting further investigation due to the known complexity of this population. Methods Set criteria were established, incorporating the core domains of CGA, designed to highlight patients needing therapy assessment, and were screened using patient questionnaires and medical notes review over a three week period. Results 53 patients were screened against the CGA domains. Rate of completion amongst CGA domains was highly variable: polypharmacy (89%); social (66%); falls (43%); nutrition (43%); continence (25%); mood (23%); cognition (21%); vision (13%); and timed up and go (9%). During the audit, consultants referred four patients to PT and none to OT, compared with screening against the established criteria, which highlighted 28 patients to PT and 22 to OT. Overall, 86% of those screened required therapy intervention. Discussion This project identified a substantial number of patients are failing to receive full, effective CGA including onward therapy intervention, which is key in identifying and managing frailty and improved patient outcomes. Conclusions This audit highlights the value and need for a multi-disciplinary approach, including PT and OT assessment, within CGA outpatient clinics, to ensure a holistic review of and intervention in the complex needs of older adults.

Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

2021 ◽  
pp. 000313482199506
Author(s):  
Youngbae Jeon ◽  
Kyoung-Won Han ◽  
Won-Suk Lee ◽  
Jeong-Heum Baek
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Nonsurgical Treatment ◽  
Perioperative Outcomes ◽  
Rank Test ◽  
Kaplan Meier ◽  
Number Of Patients

Purpose This study is aimed to evaluate the clinical outcomes of surgical treatment for nonagenarian patients with colorectal cancer. Methods This retrospective single-center study included patients diagnosed with colorectal cancer at the age of ≥90 years between 2004 and 2018. Patient demographics were compared between the operation and nonoperation groups (NOG). Perioperative outcomes, histopathological outcomes, and postoperative complications were evaluated. Overall survival was analyzed using Kaplan-Meier methods and log-rank test. Results A total of 31 patients were included (16 men and 15 women), and the median age was 91 (range: 90‐96) years. The number of patients who underwent surgery and who received nonoperative management was 20 and 11, respectively. No statistical differences in baseline demographics were observed between both groups. None of these patients were treated with perioperative chemotherapy or radiotherapy. Surgery comprised 18 (90.0%) colectomies and 2 (10.0%) transanal excisions. Short-term (≤30 days) and long-term (31‐90 days) postoperative complications occurred in 7 (35.0%) and 4 (20.0%) patients, respectively. No complications needed reoperation, such as anastomosis leakage or bleeding. No postoperative mortality occurred within 30 days: 90-day postoperative mortality occurred in two patients (10.0%), respectively. The median overall survival of the operation group was 31.6 (95% confidence interval: 26.7‐36.5) and that of NOG was 12.5 months (95% CI: 2.4‐22.6) ( P = 0.012). Conclusion Surgical treatment can be considered in carefully selected nonagenarian patients with colorectal cancer in terms of acceptable postoperative morbidity, with better overall survival than the nonsurgical treatment.

Sign in / Sign up

Export Citation Format

Share Document