Relevance of Geriatric Assessment in Older Patients With Colorectal Cancer
| Autor: | Hans Wildiers, Koen Milisen, Erik Van Cutsem, Jacques De Greve, Lore Decoster, Johan Flamaing, Jean-Pierre Lobelle, Leen Vanacker, Jacques Van der Auwera, Ellen Van Eetvelde, Cindy Kenis, Katrien Van Puyvelde, Hans Prenen |
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| Přispěvatelé: | Laboratory of Molecular and Medical Oncology, Clinical sciences, Faculty of Medicine and Pharmacy, Medical Oncology, Surgery, Frailty in Ageing, Research in Geriatrics and Gerontology, Gerontology |
| Rok vydání: | 2017 |
| Předmět: |
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medicine.medical_specialty Activities of daily living Colorectal cancer Psychological intervention Biologic age elderly 03 medical and health sciences 0302 clinical medicine Geriatric Assessment/methods Internal medicine treatment decision Activities of Daily Living medicine Humans Prospective Studies 030212 general & internal medicine Stage (cooking) Prospective cohort study Geriatric Assessment Depression (differential diagnoses) FUNCTIONAL DECLINE Aged business.industry Gastroenterology Chemotherapy-related toxicity medicine.disease Oncology Colorectal Neoplasms/therapy 030220 oncology & carcinogenesis Toxicity Physical therapy Cohort studies Female Human medicine Colorectal Neoplasms aged 80 and over business Cohort study |
| Zdroj: | Clinical colorectal cancer |
| ISSN: | 1533-0028 |
| DOI: | 10.1016/j.clcc.2016.07.010 |
| Popis: | Introduction This study aims to evaluate the relevance of geriatric assessment (GA) in older patients with colorectal cancer (CRC) and to study functional status (FS) and chemotherapy-related toxicity during treatment. Methods Patients with CRC aged ≥ 70 years were evaluated at baseline using a GA. Results were communicated to the treating physician. At 2 to 3 months follow-up, FS was reassessed, and chemotherapy-related toxicity was recorded. Results A total of 193 patients, with a median age of 77 years, were included. GA was abnormal in 75% and revealed unknown problems in 40%. Treatment was altered in 37% based on clinical assessment. GA led to geriatric interventions in 9 patients (5%) and additionally influenced treatment in 1 patient. At follow-up (n = 164), functional decline was observed in 29 patients (18%) for activities of daily living (ADL) and in 60 patients (37%) for instrumental activities of daily living (IADL). Baseline IADL, depression, fatigue, and cognition were predictors for ADL decline, whereas no predictors for IADL decline could be identified. In the 109 patients receiving chemotherapy, stage and baseline fatigue were predictive for grade 3/4 hematologic toxicity, and baseline ADL, fatigue, and nutrition were predictive for grade 3/4 nonhematologic toxicity. Conclusion Although GA identified previously unknown problems in more than one-third of older CRC patients, the impact on interventions or treatment decisions was limited. Baseline GA parameters may predict functional decline and chemotherapy-related toxicity. Education of physicians treating older patients with CRC is an essential step in the implementation of GA and subsequent interventions. |
| Databáze: | OpenAIRE |
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