Rabia Boulahssass1, Sebastien Gonfrier2, Jean-Marc Ferrero3, Marine Sanchez4, Véronique Mari5, Olivier Moranne6, Cyrielle Rambaud7, Francine Auben8, Jean-Michel Hannoun Levi9, Jean-Marc Bereder10, Isabelle Bereder11, Patrick Baque12, Jean Michel Turpin13, Anne-Claire Frin14, Delphine Ouvrier15, Delphine Borchiellini16, Remy Largillier17, Guillaume Sacco18, Jerome Delotte19, Cyprien Arlaud20, Daniel Benchimol21, Matthieu Durand22, Ludovic Evesque23, Abakar Mahamat24, Gilles Poissonnet25, Jérôme Mouroux26, Jérôme Barriere27, Emmanuel Benizri28, Thierry Piche29, Joel Guigay30, Eric Francois31, Olivier Guerin32. 1. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France; FHU ONCOAGE; Nice, France. Electronic address: boulahssass.r@chu-nice.fr. 2. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France. Electronic address: gonfrier.s@chu-nice.fr. 3. University of Nice Sophia Antipolis, France; Department of Medical Oncology, Lacassagne Center; Nice, France. Electronic address: jean-marc.ferrero@nice.unicancer.fr. 4. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France. Electronic address: sanchez.m@chu-nice.fr. 5. Department of Medical Oncology, Lacassagne Center; Nice, France. Electronic address: veronique.mari@nice.unicancer.fr. 6. Department of Nephrology, Hopital Caremeau Nimes, France; Institut Universitaire de Recherche Clinique - EA2415 - Epidémiologie, Biostatistiques et Santé Publique/University of Montpellier; Nice, France. Electronic address: Olivier.MORANNE@chu-nimes.fr. 7. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France. Electronic address: rambaud-collet.c@chu-nice.fr. 8. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France. Electronic address: auben.f@gmail.com. 9. University of Nice Sophia Antipolis, France; Department of Medical Oncology, Lacassagne Center; Nice, France. Electronic address: jean-michel.hannoun-levi@nice.unicancer.fr. 10. Department of Surgical Digestive Oncology, CHU de Nice; Nice, France. Electronic address: bereder.jm@chu-nice.fr. 11. Geriatric Department CHU de NICE, France. Electronic address: bereder.i@chu-nice.fr. 12. University of Nice Sophia Antipolis, France; University of Nice Sophia Antipolis, Emergency Surgery Unit, CHU de Nice; Nice, France. Electronic address: baque.p@chu-nice.fr. 13. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France. Electronic address: turpin.jm@chu-nice.fr. 14. Unit of Medical Oncology, Department of Gastroenterology, CHU Nice, Nice, France. Electronic address: frin.ac@chu-nice.fr. 15. Unit of Medical Oncology, Department of Gastroenterology, CHU Nice, Nice, France. Electronic address: ouvrier.d@chu-nice.fr. 16. Department of Medical Oncology, Lacassagne Center; Nice, France. Electronic address: delphine.borchiellini@nice.unicancer.fr. 17. Cancer Center: Centre Azuréen de Cancérologie; Mougins, France. Electronic address: r.largillier@gmail.com. 18. University of Nice Sophia Antipolis, France; Geriatric Department CHU de NICE, France; CoBtek, France. Electronic address: sacco.g@chu-nice.fr. 19. University of Nice Sophia Antipolis, France; Department of Obstetrics and Gynecology, Reproduction and Fetal Medicine, CHU de Nice; Nice, France. Electronic address: delotte.j@chu-nice.fr. 20. Geriatric Department CHU de NICE, France. Electronic address: arlaud.c@chu-nice.fr. 21. University of Nice Sophia Antipolis, France; Department of Surgical Digestive Oncology, CHU de Nice; Nice, France. Electronic address: danielbe3@clalit.org.il. 22. University of Nice Sophia Antipolis, France; Department of Urology, CHU de Nice, University of Nice Sophia-Antipolis; Nice, France. Electronic address: durand.m@chu-nice.fr. 23. Department of Medical Oncology, Lacassagne Center; Nice, France. Electronic address: ludovic.evesque@nice.unicancer.fr. 24. Tzanck Clinic, Saint Laurent du Var, France. Electronic address: a.mahamat@tzanck.org. 25. Department of Surgical Oncology, Lacassagne Center; Nice, France. Electronic address: gilles.poissonnet@nice.unicancer.fr. 26. University of Nice Sophia Antipolis, France; Department of Thoracic and Cardiovascular Surgery, Hopital Pasteur, CHU Nice, Nice, France. Electronic address: mouroux.j@chu-nice.fr. 27. Department of Medical Oncology: Clinic Saint Jean; Cagnes sur Mer France. Electronic address: drbarriere@orange.fr. 28. University of Nice Sophia Antipolis, France; Geriatric Department CHU de NICE, France. Electronic address: benizri.e@chu-nice.fr. 29. University of Nice Sophia Antipolis, France; Unit of Medical Oncology, Department of Gastroenterology, CHU Nice, Nice, France. Electronic address: piche.t@chu-nice.fr. 30. FHU ONCOAGE; Nice, France; University of Nice Sophia Antipolis, France; Department of Medical Oncology, Lacassagne Center; Nice, France. Electronic address: joel.guigay@nice.unicancer.fr. 31. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France; Department of Medical Oncology, Lacassagne Center; Nice, France. Electronic address: eric.francois@nice.unicancer.fr. 32. Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est CHU de NICE, France; FHU ONCOAGE; Nice, France; University of Nice Sophia Antipolis, France. Electronic address: olivier.guerin@nice.unicancer.fr.
Abstract
BACKGROUND: Predicting early death after a comprehensive geriatric assessment (CGA) is very difficult in clinical practice. The aim of this study was to develop a scoring system to estimate risk of death at 100 days in elderly cancer patients to assist the therapeutic decision. METHODS: This was a multicentric, prospective cohort study approved by an ethics committee. Elderly cancer patients aged older than 70 years were enrolled before the final therapeutic decision. A standardised CGA was made before the treatment decision at baseline. Within 100 days, event (death), oncologic and geriatric data were collected. Multivariate logistic regression was used to select the risk factors for the overall population. Score points were assigned to each risk factor using the β coefficient. Internal validation was performed by a bootstrap method. Calibration was assessed with the Hosmer-Lemeshow goodness of fit test and accuracy with the mean c-statistic. FINDINGS: One thousand fifty patients (mean age: 82 years) joined the study from April 2012 to December 2014. The independent predictors were metastatic cancers (odds ratio [OR] 2.5; 95% confidence interval [CI], [1.7-3.5] p<0 .001); gait speed<0.8 m/s (OR 2.1; 95% CI [1.3-3.3] p=0.001); Mini Nutritional Assessment (MNA) < 17 (OR 8; 95% CI; [3.7-17.3] p<0.001), MNA ≤23.5 and ≥ 17 (OR 4.4; 95% CI, [2.1-9.1) p<0.001); performance status (PS) > 2 (OR 1.7; 95% CI, [1.1-2.6)] p=0.015) and cancers other than breast cancer (OR 4; 95% CI, [2.1-7.9] p<0.001). We attributed 4 points for MNA<17, 3 points for MNA between ≤23.5 and ≥ 17, 2 points for metastatic cancers, 1 point for gait speed <0.8 m/s, 1 point for PS > 2 and 3 points for cancers other than breast cancer. The risk of death at 100 days was 4% for 0 to 6 points, 24% for 7 to 8 points, 39% for 9 to 10 points and 67% for 11 points. INTERPRETATION: To our knowledge, this is the first score which estimates early death in elderly cancer patients. The system could assist in the treatment decision for elderly cancer patients.
BACKGROUND: Predicting early death after a comprehensive geriatric assessment (CGA) is very difficult in clinical practice. The aim of this study was to develop a scoring system to estimate risk of death at 100 days in elderly cancerpatients to assist the therapeutic decision. METHODS: This was a multicentric, prospective cohort study approved by an ethics committee. Elderly cancerpatients aged older than 70 years were enrolled before the final therapeutic decision. A standardised CGA was made before the treatment decision at baseline. Within 100 days, event (death), oncologic and geriatric data were collected. Multivariate logistic regression was used to select the risk factors for the overall population. Score points were assigned to each risk factor using the β coefficient. Internal validation was performed by a bootstrap method. Calibration was assessed with the Hosmer-Lemeshow goodness of fit test and accuracy with the mean c-statistic. FINDINGS: One thousand fifty patients (mean age: 82 years) joined the study from April 2012 to December 2014. The independent predictors were metastatic cancers (odds ratio [OR] 2.5; 95% confidence interval [CI], [1.7-3.5] p<0 .001); gait speed<0.8 m/s (OR 2.1; 95% CI [1.3-3.3] p=0.001); Mini Nutritional Assessment (MNA) < 17 (OR 8; 95% CI; [3.7-17.3] p<0.001), MNA ≤23.5 and ≥ 17 (OR 4.4; 95% CI, [2.1-9.1) p<0.001); performance status (PS) > 2 (OR 1.7; 95% CI, [1.1-2.6)] p=0.015) and cancers other than breast cancer (OR 4; 95% CI, [2.1-7.9] p<0.001). We attributed 4 points for MNA<17, 3 points for MNA between ≤23.5 and ≥ 17, 2 points for metastatic cancers, 1 point for gait speed <0.8 m/s, 1 point for PS > 2 and 3 points for cancers other than breast cancer. The risk of death at 100 days was 4% for 0 to 6 points, 24% for 7 to 8 points, 39% for 9 to 10 points and 67% for 11 points. INTERPRETATION: To our knowledge, this is the first score which estimates early death in elderly cancerpatients. The system could assist in the treatment decision for elderly cancerpatients.
Authors: Clark DuMontier; Mina S Sedrak; Wee Kheng Soo; Cindy Kenis; Grant R Williams; Kristen Haase; Magnus Harneshaug; Hira Mian; Kah Poh Loh; Siri Rostoft; William Dale; Harvey Jay Cohen Journal: J Geriatr Oncol Date: 2019-08-23 Impact factor: 3.599
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