L Decoster1, K Van Puyvelde2, S Mohile3, U Wedding4, U Basso5, G Colloca6, S Rostoft7, J Overcash8, H Wildiers9, C Steer10, G Kimmick11, R Kanesvaran12, A Luciani13, C Terret14, A Hurria15, C Kenis16, R Audisio17, M Extermann18. 1. Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Brussels lore.decoster@uzbrussel.be. 2. Department of Geriatric Medecine, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium. 3. Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, USA. 4. Department of Internal Medicine II, Jena University Hospital, Jena, Germany. 5. Department of Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova. 6. Department of Geriatric Medicine, Università Cattolica Sacro Cuore, Rome, Italy. 7. Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway. 8. Ohio State University Comprehensive Cancer Center, College of Nursing, Columbus, USA. 9. Department of General Medical Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium. 10. Border Medical Oncology, Wodonga, Australia. 11. Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, USA. 12. Department of Medical Oncology, National Cancer Centre Singapore, Singapore. 13. Division of Medical Oncology, S. Paolo Hospital, Milan, Italy. 14. Department of Medical Oncology, Centre Léon-Bérard, Lyon, France. 15. Department of Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, USA. 16. Department of General Medical Oncology and Geriatric Medecine, University Hospitals Leuven, KU Leuven, Leuven, Belgium. 17. Department of Surgery, University of Liverpool, St Helens Teaching Hospital, Liverpool, UK. 18. Moffitt Cancer Center, University of South Florida, Tampa, USA.
Abstract
BACKGROUND: Screening tools are proposed to identify those older cancer patients in need of geriatric assessment (GA) and multidisciplinary approach. We aimed to update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on the use of screening tools. MATERIALS AND METHODS: SIOG composed a task group to review, interpret and discuss evidence on the use of screening tools in older cancer patients. A systematic review was carried out and discussed by an expert panel, leading to a consensus statement on their use. RESULTS: Forty-four studies reporting on the use of 17 different screening tools in older cancer patients were identified. The tools most studied in older cancer patients are G8, Flemish version of the Triage Risk Screening Tool (fTRST) and Vulnerable Elders Survey-13 (VES-13). Across all studies, the highest sensitivity was observed for: G8, fTRST, Oncogeriatric screen, Study of Osteoporotic Fractures, Eastern Cooperative Oncology Group-Performance Status, Senior Adult Oncology Program (SAOP) 2 screening and Gerhematolim. In 11 direct comparisons for detecting problems on a full GA, the G8 was more or equally sensitive than other instruments in all six comparisons, whereas results were mixed for the VES-13 in seven comparisons. In addition, different tools have demonstrated associations with outcome measures, including G8 and VES-13. CONCLUSIONS: Screening tools do not replace GA but are recommended in a busy practice in order to identify those patients in need of full GA. If abnormal, screening should be followed by GA and guided multidisciplinary interventions. Several tools are available with different performance for various parameters (including sensitivity for addressing the need for further GA). Further research should focus on the ability of screening tools to build clinical pathways and to predict different outcome parameters.
BACKGROUND: Screening tools are proposed to identify those older cancerpatients in need of geriatric assessment (GA) and multidisciplinary approach. We aimed to update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on the use of screening tools. MATERIALS AND METHODS: SIOG composed a task group to review, interpret and discuss evidence on the use of screening tools in older cancerpatients. A systematic review was carried out and discussed by an expert panel, leading to a consensus statement on their use. RESULTS: Forty-four studies reporting on the use of 17 different screening tools in older cancerpatients were identified. The tools most studied in older cancerpatients are G8, Flemish version of the Triage Risk Screening Tool (fTRST) and Vulnerable Elders Survey-13 (VES-13). Across all studies, the highest sensitivity was observed for: G8, fTRST, Oncogeriatric screen, Study of Osteoporotic Fractures, Eastern Cooperative Oncology Group-Performance Status, Senior Adult Oncology Program (SAOP) 2 screening and Gerhematolim. In 11 direct comparisons for detecting problems on a full GA, the G8 was more or equally sensitive than other instruments in all six comparisons, whereas results were mixed for the VES-13 in seven comparisons. In addition, different tools have demonstrated associations with outcome measures, including G8 and VES-13. CONCLUSIONS: Screening tools do not replace GA but are recommended in a busy practice in order to identify those patients in need of full GA. If abnormal, screening should be followed by GA and guided multidisciplinary interventions. Several tools are available with different performance for various parameters (including sensitivity for addressing the need for further GA). Further research should focus on the ability of screening tools to build clinical pathways and to predict different outcome parameters.
Authors: L Decoster; C Kenis; D Schallier; J Vansteenkiste; K Nackaerts; L Vanacker; N Vandewalle; J Flamaing; J P Lobelle; K Milisen; J De Grève; H Wildiers Journal: Lung Date: 2017-06-20 Impact factor: 2.584
Authors: Karin Ribi; Stéphanie Rondeau; Felicitas Hitz; Ulrich Mey; Milica Enoiu; Thomas Pabst; Anastasios Stathis; Natalie Fischer; Kerri M Clough-Gorr Journal: Support Care Cancer Date: 2017-04-13 Impact factor: 3.603
Authors: Eugenie Younger; Saskia Litière; Axel Le Cesne; Olivier Mir; Hans Gelderblom; Antoine Italiano; Sandrine Marreaud; Robin Lewis Jones; Alessandro Gronchi; Winette T A van der Graaf Journal: Oncologist Date: 2018-04-12
Authors: Elisabeth J M Driessen; Judith G M van Loon; Huub A Maas; Anne-Marie C Dingemans; Maryska L G Janssen-Heijnen Journal: Lung Date: 2018-04-12 Impact factor: 2.584