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https://www.readbyqxmd.com/read/28741175/a-randomized-phase-ii-trial-of-geriatric-assessment-and-management-for-older-cancer-patients
#1
Martine T E Puts, Schroder Sattar, Michael Kulik, Mary Ellen MacDonald, Kara McWatters, Katherine Lee, Sarah Brennenstuhl, Raymond Jang, Eitan Amir, Monika K Krzyzanowska, Anthony M Joshua, Johanne Monette, Doreen Wan-Chow-Wah, Shabbir M H Alibhai
PURPOSE: Geriatric assessment and management (GAM) can identify current health issues and recommend interventions to optimize well-being of older adults, but no randomized trial has yet been completed in oncology. Therefore, a randomized phase 2 trial was conducted. METHODS: A two-group parallel single-blinded randomized phase II trial ( ClinicalTrials.gov Identifier: NCT02222259) enrolled patients aged ≥70 years, diagnosed with stage 2-4 gastrointestinal, genitourinary, or breast cancer within 6 weeks of commencing chemotherapy at Princess Margaret Cancer Centre...
July 25, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28739160/using-heat-maps-to-assess-the-multidimensional-association-of-comorbidities-with-survival-in-older-cancer-patients-treated-with-chemotherapy
#2
Jae Jin Lee, Jongphil Kim, Marina Sehovic, Lu Chen, Martine Extermann
OBJECTIVE: To date, most comorbidity studies have analyzed either a subgroup of frequent diseases, or used summary instruments such as the Charlson score or the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Yet, comorbidity is a multidimensional construct and impacts function, treatment tolerance, and survival. We assessed how heat maps can unveil specific patterns of comorbidities associated with overall survival (OS) in older cancer patients treated with chemotherapy. MATERIAL AND METHODS: We reviewed four trials that prospectively evaluated comorbidities using CIRS-G...
July 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28736363/-clinical-characteristics-and-risk-factors-affecting-outcomes-of-elderly-patients-with-non-small-cell-lung-cancer-complicated-by-chronic-obstructive-pulmonary-disease
#3
Peng Wang, Dong Zhang, Xue-Guang Guo, Bao-Jun Sun, Xiang-Qun Fang, Ge-Ping Qu, Chang-Ting Liu
OBJECTIVE: To investigate the clinical features, treatment strategy and risk factors affecting the prognosis of elderly patients with non-small cell lung cancer (NSCLC) complicated by chronic obstructive pulmonary disease (COPD). METHODS: We retrospectively analyzed the data of elderly patietns (>60 years) with newly diagnosed NSCLC complicated by COPD at the Geriatric Institution of General Hospital of PLA between January, 2000 and June, 2015. The clinical data collected included history of smoking, pulmonary function test results, initial treatments, TNM stage, chief complaints, comorbidities and laboratory tests...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28734776/a-preoperative-score-to-predict-early-death-after-pancreatic-cancer-resection
#4
Gianpaolo Balzano, Erica Dugnani, Stefano Crippa, Marina Scavini, Valentina Pasquale, Francesca Aleotti, Daniela Liberati, Alessandra Gandolfi, Giulio Belfiori, Michele Reni, Claudio Doglioni, Giacomo Ruffo, Cristina Marmorale, Massimo Falconi, Lorenzo Piemonti
BACKGROUND: This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC...
July 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#5
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28731948/managing-cancer-pain-in-older-adults
#6
Emily J Guerard, James F Cleary
Managing cancer pain in older adults can be complex and challenging. Understanding the unique needs of older patients with cancer is important to safe and effective pain management. The goals of this review are to discuss the assessment of older adults with cancer-related pain, treatment of cancer pain, and adverse effects or potential risks from treatment that are unique to older patients. A detailed pain assessment and when possible utilizing the geriatric assessment are vital to developing a cancer pain management plan...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731947/early-stage-cancer-in-older-adults-prostate-avoiding-overtreatment-and-undertreatment
#7
Vikram Narayan, Song Jiang, Christopher A Warlick
The diagnosis of prostate cancer in elderly men is likely to increase over the next several decades, owing to changing demographics and a rising population of men older than 65 years. Given the heterogeneity and well-documented challenges in screening, diagnosing, and managing indolent versus aggressive prostate cancer, the geriatric patient population is particularly vulnerable to prostate cancer treatment nuances. Clinicians must become familiar with geriatric assessment tools to better answer life-expectancy questions prior to counseling patients on treatment options...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731945/the-changing-paradigm-of-radiotherapy-in-the-elderly-population
#8
Myer Raphael Pfeffer, Philip Blumenfeld
There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731943/the-impact-of-polypharmacy-on-patient-outcomes-in-older-adults-with-cancer
#9
Ginah Nightingale, Emily Skonecki, Manpreet K Boparai
Polypharmacy is prevalent in older adults with cancer and may be advantageous for the management of certain chronic disease states, but uncertainty exists regarding potential hazards and consequences. Cancer-related therapy adds to the prevalence of polypharmacy, which can lead to compromised cancer management plans (i.e., postoperative complications, treatment delays, and/or premature treatment discontinuation). Polypharmacy has been identified as one of the domains commonly included in the Comprehensive Geriatric Assessment likely because of the potential influence on health outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731942/geriatric-assessment-and-tools-for-predicting-treatment-toxicity-in-older-adults-with-cancer
#10
Daneng Li, Enrique Soto-Perez-de-Celis, Arti Hurria
Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The geriatric assessment is a multidisciplinary evaluation that provides detailed information about a patient's functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731941/the-biology-of-aging-and-cancer-frailty-inflammation-and-immunity
#11
Xinwen Zhang, Xin Meng, Yiyin Chen, Sean X Leng, Haiyan Zhang
The majority of patients with common malignancies are older adults. Intrinsic complex biological changes of aging along with inflammation, immunosenescence, age-associated chronic diseases, and extrinsic environmental and psychosocial factors have significant impact on not only development and behavior of individual malignancies, but also physiologic reserve and vulnerability of older patients who suffer from them. As a result, clinical practice of geriatric oncology demands integration of careful geriatric assessment and management...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28708810/role-of-normalized-t-cell-subsets-in-predicting-comorbidities-in-a-large-cohort-of-geriatric-hiv-infected-patient
#12
A Calcagno, S Piconi, E Focà, S Nozza, F Carli, C Montrucchio, A M Cattelan, G Orofino, B M Celesia, V Morena, G V De Socio, G Guaraldi
BACKGROUND: Adults aging with HIV are at greater risk for several comorbidities. The CD4+ cell count and CD4+/CD8+ ratio often fail to normalize in elderly patients despite prolonged antiretroviral therapy; this has been associated with concomitant diseases and poor prognosis. METHODS: A cross-sectional analysis in antiretroviral-treated HIV-positive patients aged ≥65 years. Aim of the study was to describe the predictors of normalized T cell subsets ("nT", CD4+/CD8+ ratio ≥1 and CD4+ ≥500 cells/uL) in a cohort of geriatric HIV-positive patients and its association with HIV-associated non-AIDS conditions (HANA)...
July 8, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28705182/chemoradiation-in-elderly-esophageal-cancer-patients-rationale-and-design-of-a-phase-i-ii-multicenter-study-osage
#13
Stéphanie Servagi-Vernat, Gilles Créhange, Franck Bonnetain, Cécile Mertens, Etienne Brain, Jean François Bosset
BACKGROUND: The management of elderly patients with cancer is a therapeutic challenge and a public health problem. Definitive chemoradiotherapy (CRT) is an accepted standard treatment for patients with locally advanced esophageal cancer who cannot undergo surgery. However, there are few reports regarding tolerance to CRT in elderly patients. We previously reported results for CRT in patients aged ≥75 years. Following this first phase II trial, we propose to conduct a phase I/II study to evaluate the combination of carboplatin and paclitaxel, with concurrent RT in unresectable esophageal cancer patients aged 75 years or older...
July 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28700153/-frequent-uro-geriatric-symptoms-helpful-tools-for-general-practitioners
#14
Guillaume Altwegg, Jacques Klein, Grégory Wirth, Christophe E Iselin
Each developed country faces an aging population. Increase of age rises the risk to develop urologic pathology especially in men. Routine investigation and diagnostic of urologic pathology important, however must take into account the patient in his globality (including age, comorbidities, drug medication as well as sociocultural environment). The aim of this article is to help the general practitioner in taking decisions with frequent uro-geriatric symptoms. Bladder catheterization remains an invasive treatment and indication should be regularly re-evaluated...
November 30, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28699223/outcomes-of-head-and-neck-cancer-surgery-in-the-geriatric-population-based-on-case-volume-at-academic-centers
#15
Scharukh Jalisi, Samuel J Rubin, Kevin Y Wu, Diana N Kirke
OBJECTIVES/HYPOTHESIS: Evaluate the impact of case volume and other variables on cost and mortality after head and neck oncologic surgery in the geriatric population. STUDY DESIGN: Cross-sectional study. METHODS: The Vizient database was accessed for data on geriatric patients (age ≥65 years) who underwent surgery for head and neck cancers (excluding thyroid and skin cancer) at full member academic medical centers between 2009 and 2012. Multivariate, linear regression analyses, χ(2) tests, and analysis of variance were applied to evaluate significant associations between hospital case volume and independent variables including cost, cost index, mortality, mortality index, length of stay, length of stay index, and readmission rates...
July 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28687577/frailty-index-developed-from-a-cancer-specific-geriatric-assessment-and-the-association-with-mortality-among-older-adults-with-cancer
#16
Emily J Guerard, Allison M Deal, YunKyung Chang, Grant R Williams, Kirsten A Nyrop, Mackenzi Pergolotti, Hyman B Muss, Hanna K Sanoff, Jennifer L Lund
Background: An objective measure is needed to identify frail older adults with cancer who are at increased risk for poor health outcomes. The primary objective of this study was to develop a frailty index from a cancer-specific geriatric assessment (GA) and evaluate its ability to predict all-cause mortality among older adults with cancer. Patients and Methods: Using a unique and novel data set that brings together GA data with cancer-specific and long-term mortality data, we developed the Carolina Frailty Index (CFI) from a cancer-specific GA based on the principles of deficit accumulation...
July 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28687130/-training-and-action-research-in-a-short-stay-geriatric-oncology-unit
#17
Christine Charniot, Florence Berchouchi, Claire Marchand, Rémi Gagnayre, Georges Sebbane, Frédéric Pamoukdjian
A participative action research project was undertaken in a geriatric oncology hospital unit. It resulted in the training of paramedical staff regarding the specific care to be provided to elderly people with cancer.
July 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28665087/barriers-to-dental-attendance-in-older-patients
#18
D Shanahan, D O'Neill
Health professionals in Ireland are increasingly concerned about the quality of oral health in older patients. The aim of this study is to identify the obstacles that face this age-group when accessing dental care, so that we are in a better position to address them. A questionnaire was completed by 105 patients attending a geriatric outpatient clinic. Over 50 percent of respondents had not attended a dentist in over 36 months, for the reasons that 'I have no problem or need for treatment' (62%) and 'I have no teeth, and therefore I have no need to go' (54%)...
April 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28664916/geriatric-assessment-is-superior-to-oncologists-clinical-judgement-in-identifying-frailty
#19
Lene Kirkhus, Jūratė Šaltytė Benth, Siri Rostoft, Bjørn Henning Grønberg, Marianne J Hjermstad, Geir Selbæk, Torgeir B Wyller, Magnus Harneshaug, Marit S Jordhøy
BACKGROUND: Frailty is a syndrome associated with increased vulnerability and an important predictor of outcomes in older cancer patients. Systematic assessments to identify frailty are seldom applied, and oncologists' ability to identify frailty is scarcely investigated. METHODS: We compared oncologists' classification of frailty (onc-frail) based on clinical judgement with a modified geriatric assessment (mGA), and investigated associations between frailty and overall survival...
June 29, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28659138/the-effect-of-geriatric-intervention-in-frail-elderly-patients-receiving-chemotherapy-for-colorectal-cancer-a-randomized-trial-gerico
#20
C M Lund, K K Vistisen, C Dehlendorff, F Rønholt, J S Johansen, D L Nielsen
BACKGROUND: Better surgical techniques, chemotherapy and biological therapy have improved survival in patients with colorectal cancer (CRC), most markedly in younger patients. About half of patients over 70 years receive dose reductions or early treatment discontinuation of the planned adjuvant or first-line treatment due to side effects. The Comprehensive Geriatric Assessment (CGA) is a multidisciplinary evaluation of an elderly individual's health status. This assessment in older patients with cancer can predict survival, chemotherapy toxicity and morbidity...
June 28, 2017: BMC Cancer
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