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frailty in the elderly cancer patients

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https://www.readbyqxmd.com/read/29433963/pertuzumab-and-trastuzumab-with-or-without-metronomic-chemotherapy-for-older-patients-with-her2-positive-metastatic-breast-cancer-eortc-75111-10114-an-open-label-randomised-phase-2-trial-from-the-elderly-task-force-breast-cancer-group
#1
Hans Wildiers, Konstantinos Tryfonidis, Lissandra Dal Lago, Peter Vuylsteke, Giuseppe Curigliano, Simon Waters, Barbara Brouwers, Sevilay Altintas, Nathan Touati, Fatima Cardoso, Etienne Brain
BACKGROUND: Despite the high incidence of metastatic breast cancer and its related mortality in the elderly population, our knowledge about optimal treatment for older patients with cancer is far from adequate. We aimed to evaluate the efficacy of dual anti-HER2 treatment with or without metronomic chemotherapy in older patients with HER2-positive metastatic breast cancer. METHODS: We did a multicentre, open-label, randomised, phase 2 trial in 30 centres from eight countries in Europe, in patients with histologically proven, HER2-positive metastatic breast cancer, without previous chemotherapy for metastatic disease, who were 70 years or older, or 60 years or older with confirmed functional restrictions defined by protocol, and had a life expectancy of more than 12 weeks and a performance status according to WHO scale of 0-3...
February 9, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29423551/high-preoperative-modified-frailty-index-has-a-negative-impact-on-short-and-long-term-outcomes-of-octogenarians-with-gastric-cancer-after-laparoscopic-gastrectomy
#2
Jun Lu, Hua-Long Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Chang-Ming Huang, Chao-Hui Zheng
BACKGROUND: The proportion of elderly patients who undergo surgery has rapidly increased. However, clinical indicators that predict outcomes are limited. Frailty is thought to estimate physiological reserves, although its use has not been evaluated in laparoscopic surgical patients. This study aimed to evaluate the significance of preoperative modified frailty index (PMFI) in octogenarians undergoing a laparoscopic gastrectomy. METHODS: We reviewed prospectively collected data from 119 patients with gastric cancer (GC) aged 80 years or older who underwent a radical laparoscopic gastrectomy (RLG) between January 2007 and December 2012...
February 8, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29366857/a-simplified-frailty-index-to-predict-outcomes-after-radical-cystectomy
#3
Niranjan J Sathianathen, Stephanie Jarosek, Nathan Lawrentschuk, Damien Bolton, Badrinath R Konety
BACKGROUND: Traditional surgical risk indices are notoriously inaccurate, especially for the elderly, so there has been a trend to evaluate frailty instead. OBJECTIVE: To describe a simplified five-item frailty index for evaluating radical cystectomy outcomes and compare its predictive ability with other risk assessment tools for a total patient cohort and a subgroup of patients aged ≥65yr. DESIGN, SETTING, AND PARTICIPANTS: The National Surgical Quality Improvement Program (NSQIP) database from 2007 to 2015 was queried for radical cystectomy cases for bladder cancer...
January 20, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29362300/-prognostic-value-of-geriatric-screening-tools-in-elderly-cancer-patients
#4
Masahiro Takahashi
The elderly population is heterogeneous. Chronological age alone does not reflect heterogeneity in the aging process. It is recommended that elderly cancer patients should be evaluated for some form of geriatric assessment(GA)to detect problems, to predict treatment-related toxicities, to predict functional decline, to predict prognosis, and to assist in cancer treatment decisions. It was reported that functional status, nutritional status, mental status, polypharmacy, and comorbidity were independent prognostic factors for survival in elderly cancer patients...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29333024/a-risk-benefit-assessment-approach-to-selection-of-adjuvant-chemotherapy-in-elderly-patients-with-early-breast-cancer-a-mini-review
#5
REVIEW
Vivek Agarwala, Neha Choudhary, Sudeep Gupta
Decision-making regarding the use and selection of adjuvant chemotherapy for breast cancer in elderly patients is challenging due to the presence of age-related comorbidities, frailty, and competing causes of mortality. One area, relatively neglected in most guidelines, is the effect of competing causes of mortality on presumed benefit of adjuvant chemotherapy for breast cancer in these patients. This article utilizes a clinical case to illustrate the principles of risk-benefit assessment of adjuvant chemotherapy in elderly patients...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29150094/-geriatric-assessment-and-prognostic-scores-in-older-cancer-patient-additional-support-to-the-therapeutic-decision
#6
REVIEW
Frédéric Pamoukdjian, Evelyne Liuu, Philippe Caillet, Mathilde Gisselbrecht, Stéphane Herbaud, Pascaline Boudou-Rouquette, Laurent Zelek, Elena Paillaud
Cancer is a disease of the elderly as demonstrated by the epidemiological evolution of Western countries. Indeed, two third of cancers newly diagnosed occur over 65 years. However, older cancer patients have been often excluded from clinical trials in oncology and the extrapolation of cancer treatments in this population remains difficult in practice. Scientific societies recommend that a comprehensive geriatric assessment (CGA) be performed in patients aged 70 and over and selected using screening tools for frailty such as the G8 index...
November 14, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29141942/frailty-and-the-management-of-hematologic-malignancies
#7
Gregory A Abel, Heidi D Klepin
The majority of blood cancers occur in the elderly. This fact conspires with an aging population in many countries to make rigorous assessment for frailty increasingly important for hematologic oncologists. In this review, we first define frailty and its relevance for patients with hematologic malignancy. Next, we review current data regarding the impact of domains of frailty on outcomes for blood cancers including myelodysplastic syndromes (MDS), acute leukemia, non-Hodgkin lymphomas such as chronic lymphocytic leukemia (CLL), and multiple myeloma...
November 15, 2017: Blood
https://www.readbyqxmd.com/read/29128297/role-of-geriatric-oncologists-in-optimizing-care-of-urological-oncology-patients
#8
REVIEW
Jean-Pierre Droz, Helen Boyle, Gilles Albrand, Nicolas Mottet, Martine Puts
CONTEXT: Urological cancers are common. Since the median age of diagnosis is 60-70 yr, many patients require geriatric as well as urological evaluation if treatment is to be tailored to individual health status including comorbidities and frailty. OBJECTIVE: To review the most important features of geriatric assessment and its expected benefits. We also consider ways in which collaboration between urologists and geriatricians and geriatric teams can benefit patient well-being...
November 8, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29054805/factors-predicting-adherence-to-a-tailored-dose-adjuvant-treatment-on-the-basis-of-geriatric-assessment-in-elderly-people-with-colorectal-cancer-a-prospective-study
#9
Maite Antonio, Alberto Carmona-Bayonas, Juana Saldaña, Valentí Navarro, Cristian Tebé, Ramon Salazar, Josep Maria Borràs
BACKGROUND: Selecting elderly people with colorectal cancer (CRC) for adjuvant chemotherapy is challenging. Comprehensive geriatric assessment (CGA) can help by classifying them according to their frailty profile. The supposed benefit of chemotherapy is on the basis of the rate of treatment adherence. In this study we evaluated tolerance and adherence to tailored-dose adjuvant therapy on the basis of CGA in a cohort of older patients with high-risk stage II and stage III CRC. PATIENTS AND METHODS: This was a prospective study in 193 consecutive patients aged 75 years or older...
September 28, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29040554/frailty-syndrome-an-emerging-clinical-problem-in-the-everyday-management-of-clinical-arrhythmias-the-results-of-the-european-heart-rhythm-association-survey
#10
Stefano Fumagalli, Tatjana S Potpara, Torben Bjerregaard Larsen, Kristina H Haugaa, Dan Dobreanu, Alessandro Proclemer, Nikolaos Dagres
The age of patients presenting with complex arrhythmias is increasing. Frailty is a multifaceted syndrome characterized by an increased vulnerability to stressors and a decreased ability to maintain homeostasis. The prevalence of frailty is associated with age. The aims of this European Heart Rhythm Association (EHRA) EP Wire survey were to evaluate the proportion of patients with frailty and its influence on the clinical management of arrhythmias. A total of 41 centres-members of the EHRA Electrophysiology Research Network-in 14 European countries completed the web-based questionnaire in June 2017...
November 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29034255/perioperative-management-of-elderly-patients-with-gastrointestinal-malignancies-the-contribution-of-anesthesia
#11
REVIEW
Rudolf Mörgeli, Kathrin Scholtz, Johannes Kurth, Sascha Treskatsch, Bruno Neuner, Susanne Koch, Lutz Kaufner, Claudia Spies
INTRODUCTION: Elderly patients suffering from gastrointestinal malignancies are particularly prone to perioperative complications. Elderly patients often present with reduced physiological reserves, and comorbidities can limit treatment options and promote complications. Surgeons and anesthesiologists must be aware of strategies required to deal with this vulnerable subgroup. METHODS: We provide a brief review of current and emerging perioperative strategies for the treatment of elderly patients with gastrointestinal malignancies and frequent comorbidities...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29034254/attitudes-of-surgeons-toward-elderly-cancer-patients-a-survey-from-the-siog-surgical-task-force
#12
REVIEW
Nicole M Saur, Isacco Montroni, Federico Ghignone, Giampaolo Ugolini, Riccardo A Audisio
Cancer care in elderly patients is complex. A recent survey showed that among mostly academic surgeons, practice patterns varied in the care of elderly patients. The authors suggested three areas of intervention in improving care of this population: frailty assessment, nutritional assessment, and assessment of quality of life.
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29034253/risk-factors-for-adverse-outcome-for-elderly-patients-undergoing-curative-oncological-resection-for-gastrointestinal-malignancies
#13
REVIEW
Yukai K Lim, Christopher Jackson, Emilia L Dauway, Konrad Klaus Richter
BACKGROUND: The incidence of gastrointestinal cancer increases with age, with approximately 20% of these cases in people over 80 years of age. Due to pre-existing comorbidities, this onco-geriatric population often presents diagnostic and therapeutic challenges. METHODS: A systematic review of articles on PubMed was performed to determine the predictive ability of screening tools and their components regarding the occurrence of adverse outcomes in elderly onco-surgical patients with gastrointestinal malignancies...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28978848/initial-treatment-strategy-for-patients-newly-diagnosed-with-multiple-myeloma
#14
Hideo Yagi
In Japan, the latest trends in induction therapy for patients newly diagnosed with multiple myeloma are multi-drug combinations, including bortezomib, lenalidomide, and thalidomide. Patients <65 years old and those <70 years old who have normal cardiac and lung functions without any serious complications are good candidates for high-dose L-PAM with autologous stem cell transplantation. For successful stem cell collection, anti-cancer drugs that have a negative impact on stem cell mobilization are usually excluded from induction therapies...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28967718/outcomes-after-non-cardiac-surgery-mortality-complications-disability-and-rehospitalization
#15
Bruno Amato, Mario Santoro, Giuseppe Giugliano, Giuseppe Servillo, Veronica Di Nardo, Lorenza Di Domenico, Rita Compagna, Raffaele Izzo
In the last 25 years, the number of patients aged ≥75 years undergoing non-cardiac surgery has greatly increased. In elderly patients, frailty is significantly associated with an increased risk of adverse events, functional decline, procedural complications, prolonged hospitalization, and mortality. The relationship between frailty and increased mortality and morbidity requires an appropriate tool of assessment to accurately quantify the patient's clinical and perioperative conditions. The preoperative evaluation of elderly patients candidate for non-cardiac surgery should include assessment of frailty, sarcopenia and malnutrition, as these are related to high surgical risk...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967093/advances-in-geriatric-oncology-a-multidisciplinary-perspective
#16
Ponnandai Somasundar, Loïc Mourey, Laura Lozza, Stefania Maggi, Rob Stepney
A growing majority of people with cancer is composed of older patients. For many such patients, independence and quality of life are as important as prolongation of survival, emphasizing the need for treatments that are not only effective but also well-tolerated. Given age-related decline in organ function and the prevalence of comorbidities and polypharmacy, optimum management is complex and requires collaboration between oncologists and geriatricians. Advances in surgery now include preoperative assessment and, when indicated, prehabilitation of the patient, as well as the enhanced recovery after surgery approach...
September 27, 2017: Tumori
https://www.readbyqxmd.com/read/28966807/skin-cancer-epidemics-in-the-elderly-as-an-emerging-issue-in-geriatric-oncology
#17
REVIEW
Simone Garcovich, Giuseppe Colloca, Pietro Sollena, Bellieni Andrea, Lodovico Balducci, William C Cho, Roberto Bernabei, Ketty Peris
Skin cancer is a worldwide, emerging clinical need in the elderly white population, with a steady increase in incidence rates, morbidity and related medical costs. Skin cancer is a heterogeneous group of cancers comprising cutaneous melanoma and non-melanoma skin cancers (NMSC), which predominantly affect elderly patients, aged older than 65 years. Melanoma has distinct clinical presentations in the elderly patient and represents a challenging question in terms of clinical management. NMSC includes the basal cell carcinoma and cutaneous squamous cell carcinoma and presents a wide disease spectrum in the elderly population, ranging from low-risk to high-risk tumours, advanced and inoperable disease...
October 2017: Aging and Disease
https://www.readbyqxmd.com/read/28941581/use-of-frailty-to-predict-survival-in-elderly-patients-with-early-stage-non-small-cell-lung-cancer-treated-with-stereotactic-body-radiation-therapy
#18
Idalid Franco, Yu-Hui Chen, Fallon Chipidza, Vishesh Agrawal, John Romano, Elizabeth Baldini, Aileen Chen, Yolonda Colson, Ying Hou, David Kozono, Jon Wee, Raymond Mak
OBJECTIVES: Frailty has been shown to increase morbidity and mortality independent of age, but studies are lacking in radiation oncology. This study evaluates a modified frailty index (mFI) in predicting overall survival (OS) and non-cancer death for Stage I/II [N0M0] Non-Small-Cell Lung Cancer (NSCLC) patients treated with Stereotactic Body Radiation Therapy (SBRT). MATERIALS AND METHODS: Medical records for all patients with Stage I/II NSCLC treated at our institution with SBRT from 2009 to 2014 were reviewed...
September 20, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28940851/multidisciplinary-decision-making-regarding-chemotherapy-for-lung-cancer-patients-an-age-based-comparison
#19
K J G Schulkes, M E Hamaker, J-W J Lammers, M T M van Rens, M Geerts, L J R van Elden
Optimising decision-making in elderly patients is becoming increasingly urgent. We analysed treatment decisions and course of therapy for patients with lung cancer in different age categories: <65, 65-75, and 75 years and older. About 349 patients with lung cancer (median age 67.8 years), discussed at the multidisciplinary team meeting in the Diakonessenhuis Utrecht, the Netherlands, were reviewed. Multidisciplinary decision-making and subsequent clinical course were extracted from medical files. We found that 39% of eligible patients older than 75 years of age started treatment with chemotherapy compared to 80% of the younger patients (<65 and 65-75)...
September 21, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28802765/disparities-in-care-for-elderly-women-with-endometrial-cancer-adversely-effects-survival
#20
Anna Torgeson, Dustin Boothe, Matthew M Poppe, Gita Suneja, David K Gaffney
PURPOSE: Elderly women with endometrial cancer are at increased risk of local recurrence and cancer-specific death compared to younger women. We sought to investigate adjuvant radiotherapy (RT) practice patterns and effects on survival in elderly women with endometrial cancer. METHODS: Women from the National Cancer Data Base (NCDB) with FIGO IA grade 3 to FIGO IVA endometrial cancer diagnosed from 2004-2013 were included. Chi square analysis was used to compare the elderly (80+) and non-elderly women (18-79) and women who received RT and those that did not...
November 2017: Gynecologic Oncology
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