Tomohiro F Nishijima1, Allison M Deal2, Jennifer L Lund3, Kirsten A Nyrop4, Hyman B Muss5, Hanna K Sanoff6. 1. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: tomohiro_nishijima@med.unc.edu. 2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: Allison_Deal@med.unc.edu. 3. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: jennifer.lund@unc.edu. 4. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: kirsten_nyrop@med.unc.edu. 5. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: hyman_muss@med.unc.edu. 6. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: hanna_sanoff@med.unc.edu.
Abstract
OBJECTIVE: A geriatric assessment (GA) assesses functional age of older patients with cancer and is a well-established tool predictive of toxicity and survival. The objective of this study was to investigate the prognostic value of individual GA items. MATERIALS AND METHODS: 546 patients with cancer ≥ 65 years completed GA from 2009 to 2014 and were followed for survival status for a median of 3.7 years. The GA consisted of function, nutrition, comorbidity, cognition, psychological state, and social activity/support domains. GA items with p < 0.05 in univariable analyses for overall survival (OS) were entered into multivariable stepwise selection procedure using a Cox proportional hazards model. A prognostic scale was constructed with significant GA items retained in the final model. RESULTS: Median age was 72 years, 49% had breast cancer, and 42% had stage 3-4 cancer. Three GA items were significant prognostic factors, independent of traditional factors (cancer type, stage, age, and Karnofsky Performance Status): (1) "limitation in walking several blocks", (2) "limitation in shopping", and (3) "≥ 5% unintentional weight loss in 6 months". A three-item prognostic scale was constructed with these items. In comparison with score 0 (no positive items), hazard ratios for OS were 1.85 for score 1, 2.97 for score 2, and 8.67 for score 3. This translated to 2-year estimated survivals of 85%, 67%, 51% and 17% for scores of 0, 1, 2 and 3, respectively. CONCLUSIONS: This three-item scale was a strong independent predictor of survival. If externally validated, this could be a streamlined tool with broader applicability.
OBJECTIVE: A geriatric assessment (GA) assesses functional age of older patients with cancer and is a well-established tool predictive of toxicity and survival. The objective of this study was to investigate the prognostic value of individual GA items. MATERIALS AND METHODS: 546 patients with cancer ≥ 65 years completed GA from 2009 to 2014 and were followed for survival status for a median of 3.7 years. The GA consisted of function, nutrition, comorbidity, cognition, psychological state, and social activity/support domains. GA items with p < 0.05 in univariable analyses for overall survival (OS) were entered into multivariable stepwise selection procedure using a Cox proportional hazards model. A prognostic scale was constructed with significant GA items retained in the final model. RESULTS: Median age was 72 years, 49% had breast cancer, and 42% had stage 3-4 cancer. Three GA items were significant prognostic factors, independent of traditional factors (cancer type, stage, age, and Karnofsky Performance Status): (1) "limitation in walking several blocks", (2) "limitation in shopping", and (3) "≥ 5% unintentional weight loss in 6 months". A three-item prognostic scale was constructed with these items. In comparison with score 0 (no positive items), hazard ratios for OS were 1.85 for score 1, 2.97 for score 2, and 8.67 for score 3. This translated to 2-year estimated survivals of 85%, 67%, 51% and 17% for scores of 0, 1, 2 and 3, respectively. CONCLUSIONS: This three-item scale was a strong independent predictor of survival. If externally validated, this could be a streamlined tool with broader applicability.
Authors: Grant R Williams; Mustafa Al-Obaidi; Chen Dai; Nabiel Mir; Sai Alekha Challa; Michael Daniel; Harita Patel; Brett Barlow; Crystal Young-Smith; Olumide Gbolahan; Ravi Paluri; Smita Bhatia; Smith Giri Journal: Cancer Date: 2020-09-04 Impact factor: 6.860
Authors: Grant R Williams; Chen Dai; Smith Giri; Mustafa Al-Obaidi; Christian Harmon; Kelly M Kenzik; Andrew McDonald; Olumide Gbolahan; Darryl Outlaw; Moh'd Khushman; Joshua Richman; Smita Bhatia Journal: JCO Clin Cancer Inform Date: 2022-09
Authors: Grant R Williams; Mustafa Al-Obaidi; Christian Harmon; Chen Dai; Darryl Outlaw; Olumide Gbolahan; Moh'd Khushman; Kirsten A Nyrop; Nikesha Gilmore; Smita Bhatia; Smith Giri Journal: Cancer Date: 2022-04-11 Impact factor: 6.921
Authors: Kah Poh Loh; Supriya G Mohile; Jennifer L Lund; Ronald Epstein; Lianlian Lei; Eva Culakova; Colin McHugh; Megan Wells; Nikesha Gilmore; Mostafa R Mohamed; Charles Kamen; Valerie Aarne; Alison Conlin; James Bearden; Adedayo Onitilo; Marsha Wittink; William Dale; Arti Hurria; Paul Duberstein Journal: Oncologist Date: 2019-04-23