Development of a predictor of one-year mortality in older patients with cancer by geriatric and oncologic parameters.

Breast cancer Colorectal cancer Comprehensive geriatric assessment Prognostic tools Senior patients Survival

Journal

Journal of geriatric oncology
ISSN: 1879-4076
Titre abrégé: J Geriatr Oncol
Pays: Netherlands
ID NLM: 101534770

Informations de publication

Date de publication:
05 2020
Historique:
received: 12 04 2019
revised: 07 08 2019
accepted: 22 10 2019
pubmed: 11 11 2019
medline: 29 7 2021
entrez: 11 11 2019
Statut: ppublish

Résumé

More than 60% of the new cancer diagnoses are currently made in older adults, a highly heterogeneous population. Reliable and time-saving tools to define older adults' prognosis are needed to inform the oncologist's decisions in routine clinical practice. We sought to define a multi-domain classification tool for the prediction of all-cause one-year mortality in a cohort of older adults with solid tumors. We conducted a single-centre, prospective study of patients with solid cancer aged 65 or older and with G8 score ≤ 14. All patients underwent a comprehensive geriatric assessment (CGA) before starting their surgical or medical treatment. One-year mortality was recorded. A CGA-based prediction tool of one-year mortality was developed and subsequently validated in two independent training and testing cohorts with a 70/30 split, respectively. 162 patients were enrolled. Mean patient age was 78 ± 5.5 years. Forty-three percent of the patients were men. Colorectal and breast cancer were the most common diagnoses. The clinical variables selected for the development of the new classifier (MetaGENUA®) were: mini-nutritional assessment (MNA), instrumental day life activities (IADL), Cumulative Illness Rating Scale (CIRS), geriatric depression scale (GDS), age, and cancer stage. In our independent validation cohort, MetaGENUA® showed high specificity (0.86) and AUC = 0.71 (95% CI = 0.55-0.87). MetaGENUA® predicts one-year mortality in older patients with cancer with high specificity. As such, MetaGENUA® is predicted to reveal as a useful tool to guide the oncologist's decisions in clinical practice.

Identifiants

pubmed: 31706829
pii: S1879-4068(19)30141-9
doi: 10.1016/j.jgo.2019.10.018
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

610-616

Informations de copyright

Copyright © 2019. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of Competing Interest CG, GZ, LF, AN, PO, AB, and FM are inventors on a patent of a predictor of one-year mortality in older adults with cancer (MetaGENUA®) that was filed by the University of Genoa.

Auteurs

Chiara Giannotti (C)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Gabriele Zoppoli (G)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Lorenzo Ferrando (L)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; Memorial Sloan Kettering Cancer Center, New York, USA.

Roberto Murialdo (R)

IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Irene Caffa (I)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy.

Alice Laudisio (A)

Internal Medicine and Geriatrics Unit, Campus Bio-Medico University, Rome, Italy.

Stefano Scabini (S)

IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Emanuele Romairone (E)

IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Piero Fregatti (P)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Daniele Friedman (D)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Patrizio Odetti (P)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Alessio Nencioni (A)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. Electronic address: alessio.nencioni@unige.it.

Alberto Ballestrero (A)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. Electronic address: aballestrero@unige.it.

Fiammetta Monacelli (F)

Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. Electronic address: fiammetta.monacelli@unige.it.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH