Older Patients Treated for Lung and Thoracic Cancers: Unplanned Hospitalizations and Overall Survival

Autor: Pascale Tomasini, Laurent Greillier, Florian Correard, Patrick Villani, Coline Montegut, Anne-Laure Couderc, Fabrice Barlesi, Pascal Thomas, Emilie Nouguerède, Dominique Rey
Přispěvatelé: Unité de coordination en oncogériatrie (UCOG Paca ouest), Assistance Publique - Hôpitaux de Marseille (APHM), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Service d'oncologie multidisciplinaire innovations thérapeutiques [Hôpital Nord - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service Pharmacie [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Aix-Marseille Université - Faculté de pharmacie (AMU PHARM), Aix Marseille Université (AMU), Service de chirurgie thoracique [Hôpital Nord - APHM], Institut Gustave Roussy (IGR), Méthodes computationnelles pour la prise en charge thérapeutique en oncologie : Optimisation des stratégies par modélisation mécaniste et statistique (COMPO), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche en Cancérologie de Marseille (CRCM), Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Hôpital Nord [CHU - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
0301 basic medicine
Cancer Research
MESH: Thoracic Neoplasms
Lung Neoplasms
Multivariate analysis
[SDV]Life Sciences [q-bio]
MESH: Hospitalization
Comprehensive geriatric assessment
Systemic therapy
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
[SHS]Humanities and Social Sciences
0302 clinical medicine
MESH: Aged
80 and over
Carcinoma
Non-Small-Cell Lung
Overall survival
ComputingMilieux_MISCELLANEOUS
MESH: Geriatric Assessment
Aged
80 and over
MESH: Aged
Hand Strength
[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology
Hazard ratio
Age Factors
Hospitalization
Survival Rate
medicine.anatomical_structure
Oncology
MESH: Hand Strength
030220 oncology & carcinogenesis
Female
Pulmonary and Respiratory Medicine
medicine.medical_specialty
endocrine system
MESH: Survival Rate
[SDV.CAN]Life Sciences [q-bio]/Cancer
03 medical and health sciences
Internal medicine
medicine
Older patients
Humans
Lung cancer
Geriatric Assessment
Aged
G8
MESH: Age Factors
Lung
MESH: Humans
business.industry
Proportional hazards model
Odds ratio
Thoracic Neoplasms
medicine.disease
Confidence interval
MESH: Male
MESH: Lung Neoplasms
030104 developmental biology
Unplanned hospitalizations
business
MESH: Female
MESH: Carcinoma
Non-Small-Cell Lung
Zdroj: Clinical Lung Cancer
Clinical Lung Cancer, 2021, 22 (3), pp.e405-e414. ⟨10.1016/j.cllc.2020.06.004⟩
Clinical Lung Cancer, Elsevier, 2021, 22 (3), pp.e405-e414. ⟨10.1016/j.cllc.2020.06.004⟩
ISSN: 1525-7304
1938-0690
Popis: International audience; Background: Lung cancer affects older adults and is the leading solid tumor in terms of death. A Comprehensive Geriatric Assessment (CGA) is recommended before cancer treatment to guide therapy management.Patients and methods: This study was conducted between September 2015 and January 2019. During this period of time, all consecutive older outpatients referred for a CGA before initiation of lung or thoracic tumor treatment were included. The objectives were to describe the impact of geriatric factors on unplanned hospitalizations and overall survival (OS). The study was approved by a local ethics committee.Results: Overall, 228 patients were recruited. The median age was 78.7 ± 5 years. The majority (82%) of patients were diagnosed with non-small-cell lung cancer, and the most common (40.4%) treatment was systemic therapy. In multivariate analysis, factors associated with unplanned hospitalizations within the first 3 months were male gender (adjusted odds ratio [aOR], 3.3; 95% confidence interval [CI], 1.5-7.2), systemic therapy (aOR, 2.6; 95% CI, 1.1-6.2), and fall history (aOR, 3.6; 95% CI, 1.6-8.2). Factors associated with a decrease in OS in the multivariate Cox model analysis were male gender (hazard ratio [HR], 3.9; 95% CI, 2.1-7.3), stage IV (HR, 1.6; 95% CI, 1.0-2.6), G8 ≤ 14 (HR, 3.5; 95% CI, 1.1-11.4), systemic therapy (HR, 2.6; 95% CI, 1.2-5.5), Eastern Cooperative Oncology Group performance status ≥ 2 (HR, 2.0; 95% CI, 1.2-3.4), and impaired handgrip strength (HR, 1.6; 95% CI, 1.0-2.5).Conclusion: G8 score and handgrip strength are important to predict OS in older adults treated for thoracic tumors. In the CGA, fall history was associated with unplanned hospitalization.
Databáze: OpenAIRE
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