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Geriatric assessments cancer surgery

V Giantin, C Falci, E De Luca, E Valentini, M Iasevoli, P Siviero, S Maggi, B Martella, G Crepaldi, S Monfardini, E Manzato
: The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores...
October 10, 2016: European Journal of Cancer Care
YaoYao G Pollock, Amanda L Blackford, Stacie C Jeter, Jean Wright, Ashley Cimino-Mathews, Melissa Camp, Susan Harvey, Fariba Asrari, Nancy L Schoenborn, Vered Stearns
PURPOSE: In 2004, The National Comprehensive Cancer Network (NCCN) Guidelines incorporated omission of radiation therapy after breast-conservation surgery in women ≥70 years old with stage I, estrogen receptor-positive breast cancer who plan to receive endocrine therapy. One study demonstrated wide variation in implementing this change across 13 NCCN institutions. We evaluated the practice pattern at our institution. METHODS: We identified women ≥70 years old treated at our institution from 2009 to 2014...
November 2016: Breast Cancer Research and Treatment
B Méry, A Vallard, S Espenel, N Badie, M Thiermant, V Lambert, V Soulier, S Piqueres, K Del Santo, M Ben Mrad, G Wang, P Diao, J Langrand-Escure, R Rivoirard, J-B Guy, A Guillot, A-F Chanelière, R Gonthier, E Achour, P Fournel, N Magné
INTRODUCTION: The aim of this study was to appreciate the place and role of geriatric assessment in elderly patients with prostate cancer. MATERIALS AND METHODS: We performed a retrospective analysis of prostate cancer patients who underwent geriatric assessment during the therapeutic management from 2008 to 2014. Patient, tumor, treatment characteristics and their associated toxicity as well as the parameters of geriatric assessment were studied. The occurrence of geriatric assessment within the 3 months preceding a therapeutic decision was reviewed...
September 2016: Progrès en Urologie
William P Tew
Ovarian cancer is the seventh most common cancer in women worldwide and accounts for nearly 4% of all new cases of cancer in women. Almost half of all patients with ovarian cancer are over the age of 65 at diagnosis, and over 70% of deaths from ovarian cancer occur in this same age group. As the population ages, the number of older women with ovarian cancer is increasing. Compared to younger women, older women with ovarian cancer receive less surgery and chemotherapy, develop worse toxicity, and have poorer outcomes...
September 2016: Journal of Geriatric Oncology
Shin Yin Lee, Moussa Sissoko, Kevan L Hartshorn
Pancreatic cancer is more common in older adults, who are underrepresented in clinical trials and frequently under treated. Chronological age alone should not deter clinicians from offering treatment to geriatric patients, as they are a heterogeneous population. Geriatric assessment, frailty assessment tools, and toxicity risk scores help clinicians select appropriate patients for therapy. For resectable disease, surgery can be safe but should be done at a high-volume center. Adjuvant therapy is important; though there remains controversy on the role of radiation, chemotherapy is well studied and efficacious...
October 2016: Current Oncology Reports
Fan-Feng Chen, Fei-Yu Zhang, Xuan-You Zhou, Xian Shen, Zhen Yu, Cheng-Le Zhuang
PURPOSE: This study was performed to determine the association of frailty and nutritional status with postoperative complications after total gastrectomy (TG) with D2 lymphadenectomy in patients with gastric cancer. METHODS: Patients undergoing TG with D2 lymphadenectomy for gastric cancer between August 2014 and February 2016 were enrolled. Frailty was evaluated by sarcopenia which was diagnosed by a combination of third lumbar vertebra muscle index (L3 MI), handgrip strength, and 6-m usual gait speed...
September 2016: Langenbeck's Archives of Surgery
Yves Libert, Stéphanie Dubruille, Cindy Borghgraef, Anne-Marie Etienne, Isabelle Merckaert, Marianne Paesmans, Christine Reynaert, Myriam Roos, Jean-Louis Slachmuylder, Sandrine Vandenbossche, Dominique Bron, Darius Razavi
INTRODUCTION: Dementia is a known predictor of shorter survival times in older cancer patients. However, no empirical evidence is available to determine how much a cognitive impairment shortens survival in older patients when cancer treatment is initiated. PURPOSE: To longitudinally investigate how much a cognitive impairment detected at the initiation of cancer treatment influences survival of older patients during a two-year follow-up duration and to compare the predictive value of a cognitive impairment on patients survival with the predictive value of other vulnerabilities associated with older age...
2016: PloS One
Daisuke Makiura, Rei Ono, Junichiro Inoue, Miyuki Kashiwa, Taro Oshikiri, Tetsu Nakamura, Yoshihiro Kakeji, Yoshitada Sakai, Yasushi Miura
OBJECTIVES: The number of geriatric patients with esophageal cancer has been increasing. Geriatric syndromes such as sarcopenia might adversely affect postoperative recovery. The aim of this study was to evaluate the relationships between sarcopenia and postoperative complications, and the associations between sarcopenia and perioperative functional changes in patients with esophageal cancer following esophagectomy. MATERIALS AND METHODS: Participants comprised 104 patients who underwent esophagectomy from July 2011 to April 2015...
July 21, 2016: Journal of Geriatric Oncology
M G Huisman, M Kok, G H de Bock, B L van Leeuwen
The onco-geriatric population is increasing and thus more and more elderly will require surgery; an important treatment modality for many cancer types. This population's heterogeneity demands preoperative risk stratification, which has led to the introduction of Geriatric Assessment (GA) and associated screening tools in surgical oncology. Many reviews have investigated the use of GA in onco-geriatric patients. Discrepancies in outcomes between studies currently hamper the implementation of a preoperative GA in clinical practice...
June 21, 2016: European Journal of Surgical Oncology
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...
2016: BMC Geriatrics
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
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
Yukako Mokutani, Tsunekazu Mizushima, Makoto Yamasaki, Hiromi Rakugi, Yuichiro Doki, Masaki Mori
AIMS: The study aims to determine whether the Comprehensive Geriatric Assessment (CGA) could predict complications of colorectal cancer (CRC) surgery and identify the problems. So we compared the prognostic value of the CGA with patient characteristics and determined predictive scores. METHODS: A total of 156 patients aged 75 years and older, who underwent surgery for CRC at Osaka University Hospital, were enrolled. Each patient was examined by the CGA prospectively, and all postoperative complications were obtained from the medical records...
2016: Digestive Surgery
Linda Duska, Armin Shahrokni, Melanie Powell
Endometrial cancer is the most common gynecologic cancer, and with a median age of 62 at diagnosis, it affects a significant number of older women. With increasing age and obesity rates in the world's population, there is an anticipated concomitant increase in older women with endometrial cancer. Older women are more likely to die of endometrial cancer compared with younger patients. Reasons for this include more aggressive tumor biology, less favorable clinicopathologic features, and more advanced disease...
2016: American Society of Clinical Oncology Educational Book
Fatou Farima Bagayogo, Annick Lepage, Jean Louis Denis, Lise Lamothe, Liette Lapointe, Isabelle Vedel
BACKGROUND: the collaboration between geriatricians and cancer specialists holds significant potential for improving care outcomes for older cancer patients. The realisation of this collaboration partly depends on cancer specialists involving geriatricians in caring for their older patients. Yet only a few studies have focused on understanding the reasons for cancer specialists' choice to involve or not involve geriatricians in this care. OBJECTIVE: this study shed some light on the challenges of collaboration between geriatricians and cancer specialists...
September 2016: Age and Ageing
Barbara Brouwers, Sigrid Hatse, Lissandra Dal Lago, Patrick Neven, Peter Vuylsteke, Bruna Dalmasso, Guy Debrock, Heidi Van Den Bulck, Ann Smeets, Oliver Bechter, Jithendra Kini Bailur, Cindy Kenis, Annouschka Laenen, Patrick Schöffski, Graham Pawelec, Fabrice Journe, Ghanem-Elias Ghanem, Hans Wildiers
PURPOSE: This prospective observational study aimed to evaluate the impact of adjuvant chemotherapy on biological and clinical markers of aging and frailty. METHODS: Women ≥ 70 years old with early breast cancer were enrolled after surgery and assigned to a chemotherapy (Docetaxel and Cyclophosphamide) group (CTG, n=57) or control group (CG, n=52) depending on their planned adjuvant treatment. Full geriatric assessment (GA) and Quality of Life (QoL) were evaluated at inclusion (T0), after 3 months (T1) and at 1 year (T2)...
May 24, 2016: Oncotarget
Benedicte Rønning, Torgeir Bruun Wyller, Arild Nesbakken, Eva Skovlund, Marit Slaaen Jordhøy, Arne Bakka, Siri Rostoft
OBJECTIVE: The incidence of colorectal cancer is increasing, mainly due to the aging of the population. Frailty, describing a state of increased vulnerability, is common in older patients, but frailty and high age are not necessarily contraindications to surgical treatment. However, limited data describing long-term outcomes after surgery in this patient group exist. In this clinical follow-up study, we aimed to examine long-term health-related quality of life in older surgical patients with colorectal cancer...
May 2016: Journal of Geriatric Oncology
J Hoch, M Bláha, D Malúšková
INTRODUCTION: High incidence of colorectal cancer in the Czech Republic is an actual and demographically significant health issue. Half of all of the patients is older than 70 years. Both surgical and non-surgical treatment options in this group of patients depend on factors that are difficult to measure only by current oncological and anesthesiological classifications (cTcNcM, ASA). The objective of this paper is to measure the impact of age on the use of various treatment modalities within the protocol and their results, and also to suggest alternative options for therapy tolerance assessment...
January 2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Aarati Poudel, Shreya Sinha, Ajeet Gajra
Lung cancer is a disease of older adults. In the US and worldwide, more than 60% of patients being diagnosed are over the age of 65 years. The preferred treatment of stage I-II non-small-cell lung cancer (NSCLC) is surgical resection. Adjuvant chemotherapy with a platinum-based combination is the standard of care for patients with early-stage NSCLC after surgery. However, there have been no large prospective studies to test the efficacy of adjuvant chemotherapy in the elderly, the population most affected by lung cancer...
April 2016: Drugs & Aging
Hung-Jui Tan, Debra Saliba, Lorna Kwan, Alison A Moore, Mark S Litwin
PURPOSE: Most malignancies are diagnosed in older adults who are potentially susceptible to aging-related health conditions; however, the manifestation of geriatric syndromes during surgical cancer treatment is not well quantified. Accordingly, we sought to assess the prevalence and ramifications of geriatric events during major surgery for cancer. PATIENTS AND METHODS: Using Nationwide Inpatient Sample data from 2009 to 2011, we examined hospital admissions for major cancer surgery among elderly patients (ie, age ≥ 65 years) and a referent group age 55 to 64 years...
April 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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