Abstract
Objectives
The management of cancer in aging people remains a challenge for physicians. Specialists
agree on the assistance provided by a multidimensional geriatric assessment (MGA)
to guide the cancer treatment decision-making process. We aim to explore the use of
MGA in treatment decision and to identify MGA parameters likely to influence the planned
cancer treatment.
Material and Methods
We conducted a single-site retrospective study in patients older than 65 years suffering
from various types of cancer who underwent MGA before cancer treatment decision. Logistic
regression analyses were used for identification of predictive variables.
Results
In the 266 patients' population, the mean age was 75.8 ± 7.4 years and 155 (58%) patients
were men. Patients had solid tumors (95.4%) or hematologic malignancies (4.6%). Most
of patients were in advanced setting (57%). The MGA revealed malnutrition (47%), cognitive/mood
impairment (48%), functional decline (53%), and led to adjust medical care through
reinforcing health status and fostering successful completion of cancer treatment
plan for 259 (97%) patients.
The MGA changed cancer treatment in 47 (18%) patients. Functional and/or cognitive
impairment, risk of falls, and polypharmacy were associated with treatment change
in univariate analysis. No multivariate model was possible.
Conclusions
MGA leads to modification of treatment in only few patients. However, MGA enables
a better understanding of patients' strengths and weaknesses essential to improve
care management. Further improvements with integration of innovative specific tools
are warranted to help decision-process in the increasing complexity of treatment plans
available in older adults.
Keywords
Abbreviations:
MGA (Multidimensional Geriatric Assessment), KPS (Karnofsky Performance Status), ECOG-PS (Eastern Cooperative Oncology Group Performance Status), MMSE (Mini Mental State Examination), GDS (Geriatric Depression Scale), ADL (Activities of Daily Living), IADL (Instrumental Activities of Daily Living), POMA (Performance-Oriented Assessment of Mobility instrument), MNA (Mini Nutritional Assessment), BMI (Body Mass Index), CIRS-G (Cumulative Illness Rating Scale for Geriatrics), ELCAPA (Elderly Cancer Patient)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 01, 2018
Accepted:
May 11,
2018
Received in revised form:
February 21,
2018
Received:
October 23,
2017
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
