Comprehensive Geriatric Assessment in the Decision-Making Process in Elderly Patients With Cancer: ELCAPA Study
| العنوان: | Comprehensive Geriatric Assessment in the Decision-Making Process in Elderly Patients With Cancer: ELCAPA Study |
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| المؤلفون: | Sylvie Bastuji-Garin, Muriel Berle, Stéphane Culine, Nicoleta Reinald, Florence Canoui-Poitrine, Philippe Caillet, Elena Paillaud, Johanna Vouriot, Sébastien Krypciak |
| المصدر: | Journal of Clinical Oncology. 29:3636-3642 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2011. |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Male, Cancer Research, medicine.medical_specialty, Activities of daily living, Multivariate analysis, Decision Making, MEDLINE, Comorbidity, Rating scale, Neoplasms, Internal medicine, Activities of Daily Living, medicine, Humans, Prospective Studies, Prospective cohort study, Geriatric Assessment, Aged, Aged, 80 and over, Geriatrics, Depression, business.industry, Malnutrition, Cancer, medicine.disease, Oncology, Multivariate Analysis, Physical therapy, Female, Cognition Disorders, business |
| الوصف: | Purpose To identify Comprehensive Geriatric Assessment (CGA) components independently associated with changes in planned cancer treatment. Patients and Methods We prospectively included 375 consecutive elderly patients with cancer (ELCAPA01 study) assessed by geriatricians using the CGA. Multivariate analysis was used to identify factors associated with changes in the cancer treatment (intensification, decrease, or delayed > 2 weeks). Change was defined as a difference between the initial treatment proposal and the final treatment selected in a multidisciplinary meeting. Results Mean age was 79.6 years (standard deviation [SD], 5.6 years), and 197 (52.5%) were women. The most common tumor location was the digestive system (58.7%). The mean number of comorbidities was 4.2 (SD, 2.7) per patient, and the mean Cumulative Illness Rating Scale for Geriatrics score was 11.8 (SD, 5.3). After the CGA, the initial cancer treatment plan was modified for 78 (20.8%) of 375 patients (95% CI, 16.8 to 25.3), usually to decrease treatment intensity (63 [80.8%] of 78 patients). By univariate analysis, cancer treatment changes were associated with Eastern Cooperative Oncology Group performance status ≥ 2 (73.3% in the group with changes v 41.1% in the in the group without changes; P < .001), dependency for one or more activities of daily living (ADL; 59.0% v 24.2%; P < .001), malnutrition (81.8% v 51.2%; P < .001), cognitive impairment (38.5% v 24.9%; P = .023), depression (52.6% v 21.7%; P < .001), and greater number of comorbidities (mean, 4.8 [SD, 2.9] v 4.0 [SD, 2.6]; P = .02). By multivariate analysis, factors independently associated with cancer treatment changes were a lower ADL score (odds ratio [OR], 1.25 per 0.5-point decrease; CI, 1.04 to 1.49; P = .016) and malnutrition (OR, 2.99; CI, 1.36 to 6.58; P = .007). Conclusion Functional status assessed by the ADL score and malnutrition were independently associated with changes in cancer treatment. |
| تدمد: | 1527-7755 0732-183X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f92b0fd13ee3a253dcf3a0bc8b5e1334Test https://doi.org/10.1200/jco.2010.31.0664Test |
| رقم الانضمام: | edsair.doi.dedup.....f92b0fd13ee3a253dcf3a0bc8b5e1334 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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