Frederic Pamoukdjian1,2, Thomas Aparicio3, Sonia Zebachi2, Laurent Zelek4, Elena Paillaud2,5, Florence Canoui-Poitrine2,6. 1. Geriatric Department, Coordination Unit in Geriatric Oncology, Avicenne Hospital, APHP, Bobigny. 2. DHU A-TVB, IMRB-EA 7376 CEpiA (Clinical Epidemiology and Ageing Unit), Université Paris-Est, UPEC, Créteil. 3. Department of Gastroenterology, Avicenne Hospital, Bobigny. 4. Department of Medical Oncology, Avicenne Hospital, Bobigny. 5. Geriatric Department, Georges Pompidou European Hospital, Paris. 6. Public Health Department, Henri-Mondor Hospital, APHP, Créteil, France.
Abstract
BACKGROUND: To assess and compare the ability of five mobility indices to predict 6-month mortality in older patients with cancer. METHODS: All consecutive ambulatory older patients with cancer referred for a geriatric assessment before a cancer treatment decision were included in a prospective two-center cohort study (Physical Frailty in Elderly Cancer) between 2013 and 2017. The mobility indices compared were the short physical performance battery, gait speed, hand grip strength, the one-leg stance balance test, and repeated falls. The primary endpoint was 6-month overall mortality. The adjusted hazard ratio (95% confidence interval [CI]) for each mobility index was estimated using a multivariate Cox proportional hazard model adjusted for sex, the Cumulative Illness Rating Scale for Geriatrics, the body mass index, cancer site/extension, and the provision of supportive care alone. The models' predictive performances were assessed in terms of Harrell's C index, net reclassification improvement, and the standardized net benefit. RESULTS: A total of 603 patients included (mean age: 81.2 ± 6.1 years; women: 54%; metastatic cancer: 45%). In multivariate analyses, an impairment in any of the mobility indices (with the exception of repeated falls) was independently associated with 6-month mortality following a geriatric assessment; the adjusted hazard ratio [95% CI] ranged from 2.35 [1.34-4.13] for the one-leg stance balance (C index: 0.74) to 3.03 [1.93-4.76] for the short physical performance battery (C index: 0.77). For each mobility index, inclusion in the multivariate model improved significantly the latter's prediction of 6-month mortality. CONCLUSIONS: Among mobility tests, short physical performance battery had the best discriminative value for predicting 6-month mortality in older patients with cancer.
BACKGROUND: To assess and compare the ability of five mobility indices to predict 6-month mortality in older patients with cancer. METHODS: All consecutive ambulatory older patients with cancer referred for a geriatric assessment before a cancer treatment decision were included in a prospective two-center cohort study (Physical Frailty in Elderly Cancer) between 2013 and 2017. The mobility indices compared were the short physical performance battery, gait speed, hand grip strength, the one-leg stance balance test, and repeated falls. The primary endpoint was 6-month overall mortality. The adjusted hazard ratio (95% confidence interval [CI]) for each mobility index was estimated using a multivariate Cox proportional hazard model adjusted for sex, the Cumulative Illness Rating Scale for Geriatrics, the body mass index, cancer site/extension, and the provision of supportive care alone. The models' predictive performances were assessed in terms of Harrell's C index, net reclassification improvement, and the standardized net benefit. RESULTS: A total of 603 patients included (mean age: 81.2 ± 6.1 years; women: 54%; metastatic cancer: 45%). In multivariate analyses, an impairment in any of the mobility indices (with the exception of repeated falls) was independently associated with 6-month mortality following a geriatric assessment; the adjusted hazard ratio [95% CI] ranged from 2.35 [1.34-4.13] for the one-leg stance balance (C index: 0.74) to 3.03 [1.93-4.76] for the short physical performance battery (C index: 0.77). For each mobility index, inclusion in the multivariate model improved significantly the latter's prediction of 6-month mortality. CONCLUSIONS: Among mobility tests, short physical performance battery had the best discriminative value for predicting 6-month mortality in older patients with cancer.
Authors: Eni Shehu; Sigrid Roggendorf; André Golla; Antonia Koenig; Gabriele I Stangl; Andrea Diestelhorst; Daniel Medenwald; Dirk Vordermark; Anke Steckelberg; Heike Schmidt Journal: Cancers (Basel) Date: 2022-05-24 Impact factor: 6.575
Authors: Elizabeth Dociak-Salazar; José L Barrueto-Deza; Diego Urrunaga-Pastor; Fernando M Runzer-Colmenares; José F Parodi Journal: Heliyon Date: 2022-01-29
Authors: Jaidyn Muhandiramge; Suzanne G Orchard; Erica T Warner; Gijsberta J van Londen; John R Zalcberg Journal: Cancers (Basel) Date: 2022-03-08 Impact factor: 6.639