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https://www.readbyqxmd.com/read/28049616/three-decades-of-comprehensive-geriatric-assessment-evidence-coming-from-different-healthcare-settings-and-specific-clinical-conditions
#1
REVIEW
Alberto Pilotto, Alberto Cella, Andrea Pilotto, Julia Daragjati, Nicola Veronese, Clarissa Musacchio, Anna Maria Mello, Giancarlo Logroscino, Alessandro Padovani, Camilla Prete, Francesco Panza
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA...
December 31, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28026127/well-differentiated-bronchial-neuroendocrine-tumours-clinical-management-and-outcomes-in-105-patients
#2
Marinos Pericleous, Anna Karpathakis, Christos Toumpanakis, Heather Lumgair, Jonathan Reiner, Laura Marelli, Christina Thirlwell, Martyn E Caplin
INTRODUCTION: Bronchial neuroendocrine tumours (NETs) are rare tumours representing approximately 20-30% of all neuroendocrine tumours and 2-3% of all adult lung cancers. Here, we present a large case series of well-differentiated bronchial NETs with the aim of investigating the behaviour of these tumours and long-term outcomes. METHODS: A retrospective review was performed of 105 patients with bronchial NETs managed in a tertiary referral centre in the period between January 1998-January 2012...
December 27, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28012116/serum-chromogranin-a-as-a-complementary-marker-for-the-prediction-of-prostate-cancer-specific-survival
#3
Christian Niedworok, Stephan Tschirdewahn, Henning Reis, Nils Lehmann, Miklós Szücs, Péter Nyirády, Imre Romics, Herbert Rübben, Tibor Szarvas
Better prognostication of clinically localized prostate cancer (PCA) is urgently needed. Former studies using different study end-points provided controversial results regarding the prognostic value of serum chromogranin A (CGA) in clinically localized PCA. However, serum CGA was not tested for correlation with the most significant study end-point of long-term disease-specific survival (DSS). CGA and matrix metalloproteinase-7 (MMP7) levels were measured by the BRAHMS KRYPTOR in two independent patient groups with 127 serum and 110 plasma samples...
December 23, 2016: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/27964884/abridged-geriatric-assessment-is-a-better-predictor-of-overall-survival-than-the-karnofski-performance-scale-and-physical-performance-test-in-elderly-cancer-patients
#4
Marwan Ghosn, Tony Ibrahim, Elie El Rassy, Najib Nassani, Sassine Ghanem, Tarek Assi
OBJECTIVES: Comprehensive geriatric assessment (CGA) is a complex and interdisciplinary approach to evaluate the health status of elderly patients. The Karnofsky Performance Scale (KPS) and Physical Performance Test (PPT) are less time-consuming tools that measure functional status. This study was designed to assess and compare abridged geriatric assessment (GA), KPS and PPT as predictive tools of mortality in elderly cancer patients. MATERIALS AND METHODS: This prospective interventional study included all individuals aged >70years who were diagnosed with cancer during the study period...
December 7, 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/27847786/use-of-a-comprehensive-geriatric-assessment-to-predict-short-term-postoperative-outcome-in-elderly-patients-with-colorectal-cancer
#5
Yoon Hyun Lee, Heung-Kwon Oh, Duck-Woo Kim, Myong Hoon Ihn, Jee Hyun Kim, Il Tae Son, Sung Il Kang, Gwang Il Kim, Soyeon Ahn, Sung-Bum Kang
PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA...
October 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27812859/palliative-care-of-cancer-in-the-older-patient
#6
REVIEW
Lodovico Balducci, Dawn Dolan
The scope of palliative care includes goal setting, symptom management, and care of the care giver. Palliative care is essential for patient-centered care of the older cancer patients. The diversity of this population in terms of life expectancy, treatment tolerance, function, disability, and social support mandates personalized treatment plans. The assessment of physiologic age is currently based on a comprehensive geriatric assessment (CGA). A number of biologic markers of aging including the inflammatory index, the genomic clock, the expression of p16INKa4, and the circulating levels of vitamin D may complement the CGA and fine-tune the determination of physiologic age...
December 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27683038/regulation-of-tumor-growth-by-circulating-full-length-chromogranin-a
#7
Flavio Curnis, Alice Dallatomasina, Mimma Bianco, Anna Gasparri, Angelina Sacchi, Barbara Colombo, Martina Fiocchi, Laura Perani, Massimo Venturini, Carlo Tacchetti, Suvajit Sen, Ricardo Borges, Eleonora Dondossola, Antonio Esposito, Sushil K Mahata, Angelo Corti
Chromogranin A (CgA), a neuroendocrine secretory protein, and its fragments are present in variable amounts in the blood of normal subjects and cancer patients. We investigated whether circulating CgA has a regulatory function in tumor biology and progression. Systemic administration of full-length CgA, but not of fragments lacking the C-terminal region, could reduce tumor growth in murine models of fibrosarcoma, mammary adenocarcinoma, Lewis lung carcinoma, and primary and metastatic melanoma, with U-shaped dose-response curves...
September 24, 2016: Oncotarget
https://www.readbyqxmd.com/read/27634104/chlorogenic-acid-prevents-isoproterenol-induced-dna-damage-in-vascular-smooth-muscle-cells
#8
Jingshuai Wang, Jiyang Li, Jie Liu, Mengjiao Xu, Xiaowen Tong, Jianjun Wang
Numerous clinical therapeutic agents have been identified as DNA damaging. The present study revealed that isoproterenol (Iso) resulted in DNA damage in vascular smooth muscle cells (VSMCs) and increased the levels of intracellular oxygen free radicals. Administration of chlorogenic acid (CGA) inhibited this effect. Pretreatment with CGA abrogated the increase in protein expression levels of γ‑H2A histone family member X, phosphorylated ataxia telangiectasia mutated, phosphorylated Rad3‑related protein, breast cancer 1 and C‑terminal Src homologous kinase induced by Iso...
November 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27630826/treatment-of-elderly-patients-with-squamous-cell-carcinoma-of-the-head-and-neck
#9
REVIEW
Petr Szturz, Jan B Vermorken
The demographics of squamous cell carcinoma of the head and neck (SCCHN) is marked by a growing number of patients aged 65 and over, which is in line with global projections for other cancer types. In developed countries, more than half of new SCCHN cases are diagnosed in older people, and in 15 years from now, the proportion is expected to rise by more than 10%. Still, a high-level evidence-based consensus to guide the clinical decision process is strikingly lacking. The available data from retrospective studies and subset analyses of prospective trials suffer from a considerable underrepresentation of senior participants...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27606136/kras-mutation-in-small-cell-lung-carcinoma-and-extrapulmonary-small-cell-cancer
#10
Hilmi Kodaz, Ebru Taştekin, Bülent Erdoğan, İlhan Hacıbekiroğlu, Hilmi Tozkır, Hakan Gürkan, Esma Türkmen, Bora Demirkan, Sernaz Uzunoğlu, İrfan Çiçin
BACKGROUND: Lung cancer is one of the most lethal cancers. It is mainly classified into 2 groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Extrapulmonary small cell carcinomas (EPSCC) are very rare. The Ras oncogene controls most of the cellular functions in the cell. Overall, 21.6% of human cancers contain a Kirsten Ras (KRAS) mutation. SCLC and EPSCC have several similar features but their clinical course is different. AIMS: We investigated the KRAS mutation status in SCLC and EPSCC...
July 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27603595/chlorogenic-acid-induces-reactive-oxygen-species-generation-and-inhibits-the-viability-of-human-colon-cancer-cells
#11
Ni Hou, Na Liu, Jia Han, Yuan Yan, Jie Li
Chlorogenic acid (CGA) is one of the polyphenols identified in the human diet. Previous studies have shown that CGA plays a protective role against liver diseases. The colon plays a pivotal role in CGA metabolism. However, little is known about the direct effects and the underlying molecular mechanisms of CGA in colon cancer. Here, we investigate these mechanisms of CGA activity in human colon cancer cells. The effects of CGA on the viability of two human colon cancer cell lines, HCT116 and HT29, were determined using the MTT assay...
January 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/27579728/predictive-comprehensive-geriatric-assessment-in-elderly-prostate-cancer-patients-the-prospective-observational-scoop-trial-results
#12
Chiara Della Pepa, Carla Cavaliere, Sabrina Rossetti, Marilena Di Napoli, Sabrina C Cecere, Anna Crispo, Carlo De Sangro, Emanuela Rossi, Dino Turitto, Domenico Germano, Gelsomina Iovane, Massimiliano Berretta, Carmine D'Aniello, Salvatore Pisconti, Luigi Maiorino, Bruno Daniele, Cesare Gridelli, Sandro Pignata, Gaetano Facchini
The Comprehensive Geriatric Assessment (CGA) represents the future of the geriatric oncology to reduce toxicities and treatment-related hospitalization in the elderly. Most patients receiving docetaxel for metastatic castration-resistant prostate cancer are in their seventies or older. We explored the efficacy of the CGA in predicting chemotherapy feasibility and response to docetaxel in a cohort of 24 patients aged at least 70. This was an observational, prospective study involving 24 patients who were 70 years of age or older and about to start chemotherapy with docetaxel for metastatic castration-resistant prostate cancer; we performed a CGA including five domains and divided our patients into 'healthy' and 'frail'; the relations between general condition and (i) early chemotherapy discontinuation and (ii) response to docetaxel were explored...
January 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/27539034/-pharmacotherapeutic-treatment-of-elderly-cancer-patients
#13
Masayuki Yokode
Age-specific analyses of mortality rates in Japan show that cancer was the leading cause of death for the age group 40-89 years in the year 2013. Although the crude mortality rate from cancer has recently increased, the age-adjusted cancer mortality rate has shown a decreasing trend. This suggests that the increases in the crude mortality rate may have been caused by the aging of the population. Cancer patients who are old present many comorbidities and newly diagnosed geriatric problems. Several tools provide determinants of survival in cancer patients who are old (including the comprehensive geriatric assessment [CGA]) in order to improve the quality of cancer care in this population...
August 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/27529755/frailty-as-determined-by-a-comprehensive-geriatric-assessment-derived-deficit-accumulation-index-in-older-patients-with-cancer-who-receive-chemotherapy
#14
Harvey Jay Cohen, David Smith, Can-Lan Sun, William Tew, Supriya G Mohile, Cynthia Owusu, Heidi D Klepin, Cary P Gross, Stuart M Lichtman, Ajeet Gajra, Julie Filo, Vani Katheria, Arti Hurria
BACKGROUND: Frailty has been suggested as a construct for oncologists to consider in treating older cancer patients. Therefore, the authors assessed the potential of creating a deficit-accumulation frailty index (DAFI) from a largely self-administered comprehensive geriatric assessment (CGA). METHODS: Five hundred patients aged ≥65 years underwent a CGA before receiving chemotherapy. A DAFI was constructed, resulting in a 51-item scale, and cutoff values were examined for patients in the robust/nonfrail (cutoff value, 0...
December 15, 2016: Cancer
https://www.readbyqxmd.com/read/27388509/association-of-pre-operative-medication-use-with-post-operative-delirium-in-surgical-oncology-patients-receiving-comprehensive-geriatric-assessment
#15
Young Mi Jeong, Eunsook Lee, Kwang-Il Kim, Jee Eun Chung, Hae In Park, Byung Koo Lee, Hye Sun Gwak
BACKGROUND: Older patients undergoing surgery tend to have a higher frequency of delirium. Delirium is strongly associated with poor surgical outcomes. This study evaluated the association between pre-operative medication use and post-operative delirium (POD) in surgical oncology patients receiving comprehensive geriatric assessment (CGA). METHODS: A total of 475 patients who were scheduled for cancer surgery and received CGA from January 2014 to June 2015 were included...
July 7, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27368883/an-introduction-to-a-head-and-neck-cancer-specific-frailty-index-and-its-clinical-implications-in-elderly-patients-a-prospective-observational-study-focusing-on-respiratory-and-swallowing-functions
#16
Minsu Kwon, Shin-Ae Kim, Jong-Lyel Roh, Sang-Wook Lee, Sung-Bae Kim, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim
INTRODUCTION: Frailty refers to a decreased physiologic reserve in geriatric patients and its importance in terms of treatment planning and outcome prediction has been emphasized in oncologic practices for older patients with cancer. We investigated the clinical implications of a head and neck cancer (HNC)-specific frailty index suggested by prospective clinical and functional evaluations of HNC patients. MATERIALS AND METHODS: We analyzed data on 165 elderly patients with HNC who were prospectively enrolled in our hospital from 2010 to 2013...
September 2016: Oncologist
https://www.readbyqxmd.com/read/27342942/-non-small-cell-lung-cancer-irradiation-in-elderly
#17
G Dupic, A Bellière-Calandry
People over the age of 65 are often excluded from participation in oncological clinical trials. However, more than half of patients diagnosed with non-small-cell lung cancer are older than 65 years. Any therapeutic strategy must be discussed in multidisciplinary meetings after adapted geriatric assessment. Patients who benefit from the comprehensive geriatric assessment (CGA) of Balducci and Extermann are those whose G8 screening tool score is less than or equal to 14. Age itself does not contraindicate a curative therapeutic approach...
June 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/27313080/impact-of-geriatric-assessment-on-the-management-of-older-adults-with-head-and-neck-cancer-a-pilot-study
#18
Matthew Neve, Michael B Jameson, Siva Govender, Cristian Hartopeanu
OBJECTIVE: Assess the utility of the G8 screening tool and CGA for older adults with head and neck cancer. METHODS: Patients 65years or older with a primary malignancy of the head and neck region were presented at the multidisciplinary team (MDT) meeting. The Geriatric 8 (G8) questionnaire was administered prior. Clinicians, blinded to the G8 result, made a recommendation on appropriate treatment, including potential referral for CGA. Patients considered vulnerable (G8 score≤14) were also to be referred for CGA...
November 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/27272271/risk-evaluation-of-postoperative-delirium-using-comprehensive-geriatric-assessment-in-elderly-patients-with-esophageal-cancer
#19
Masaaki Yamamoto, Makoto Yamasaki, Ken Sugimoto, Yoshihiro Maekawa, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Kiyokazu Nakajima, Shuji Takiguchi, Hiromi Rakugi, Masaki Mori, Yuichiro Doki
BACKGROUND: The number of geriatric patients with esophageal cancer is increasing in step with the aging of the population. Geriatric patients have a higher risk of postoperative complications, including delirium that can cause a fall or impact survival. Therefore, it is very important that we evaluate risks of postoperative complications before surgery. The aim of this study was to predict postoperative delirium in elderly patients. METHODS: We retrospectively reviewed the medical records of 91 patients aged 75 years and over who underwent esophagectomy between January 2006 and December 2014...
November 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27267093/practice-pearls-in-the-management-of-lung-cancer-in-the-elderly
#20
REVIEW
Ravindran Kanesvaran, Anupama Roy Chowdhury, Lalit Krishna
Lung cancer is a disease that afflicts the elderly. It is a leading cause of cancer mortality worldwide. Treatment of lung cancer which was predominantly combination chemotherapy was initially thought to be too toxic for older patients with cancer due to their frail state. However a number of recent studies have shown that this is not necessarily true and many elderly can actually tolerate combination chemotherapy and derive just as much benefit from it as younger patients with lung cancer do. More recently it has been found that a significant proportion of lung cancer patients have tumors that harbor mutations that are targetable by molecularly targeted therapy (MTT)...
September 2016: Journal of Geriatric Oncology
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