Anne-Laure Couderc1, Pascale Tomasini2, Dominique Rey3, Emilie Nouguerède3, Florian Correard4, Fabrice Barlesi5, Pascal Thomas6, Patrick Villani7, Laurent Greillier2. 1. Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France and Coordination Unit for Geriatric Oncology (UCOG), PACA West, France; Aix-Marseille Univ, CNRS, EFS, ADES, Marseille, France. Electronic address: anne-laure.couderc@ap-hm.fr. 2. Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France; Aix-Marseille Univ, CNRS, INSERM, CRCM, Marseille, France. 3. Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France and Coordination Unit for Geriatric Oncology (UCOG), PACA West, France. 4. Pharmacology Department, AP-HM, France; Aix-Marseille Univ, Clinical Pharmacy Unit, Marseille, France. 5. Aix-Marseille Univ, CNRS, INSERM, CRCM, Marseille, France; Gustave Roussy Cancer Campus, Villejuif, France. 6. Aix-Marseille Univ, CNRS, INSERM, CRCM, Marseille, France; Thoracic Surgery Unit, AP-HM, Marseille, France. 7. Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, Marseille, France and Coordination Unit for Geriatric Oncology (UCOG), PACA West, France; Aix-Marseille Univ, CNRS, EFS, ADES, Marseille, France.
Abstract
BACKGROUND: Lung cancer affects older and older old adults and is the leading cause of death by cancer. Comprehensive Geriatric Assessment (CGA) is recommended before and during cancer treatment to guide therapy management in this population. METHODS: This study was conducted between September 2015 and January 2019 at Marseille University Hospital (AP-HM). During this period, all consecutive outpatients 70 years or older referred for a CGA before initiation of lung cancer treatment were enrolled. The objective of this study was to compare lung and thoracic cancer management of octogenarians (≥80 years) and their geriatric profile versus patients aged 70 to 79 years (<80 years). FINDINGS: In our study, 228 patients were recruited. The median age was 78.7 ± 5 years. There were 94 octogenarians (41.2%), 36.2% of them were diagnosed with stage IV neoplasm and the most common treatment was chemotherapy (43.6%). The logistic regression analysis highlights that handgrip strength was the most commonly impaired domain (OR 2.3; 95% CI [1.3-4.3]) in octogenarians and that they are more likely than their younger counterparts to be treated by targeted therapy (OR 9.8; 95% CI [1.0-92.9]). Overall survival (OS) was similar in both age groups (log rank = 0,95). INTERPRETATION: In our study, octogenarians and patients <80 years had equivalent survival, across the different thoracic cancer treatments and tumor stages. Measure of muscle strength in CGA could be very useful in a clinical setting to help improve the management of older old patients treated for lung or thoracic cancer.
BACKGROUND:Lung cancer affects older and older old adults and is the leading cause of death by cancer. Comprehensive Geriatric Assessment (CGA) is recommended before and during cancer treatment to guide therapy management in this population. METHODS: This study was conducted between September 2015 and January 2019 at Marseille University Hospital (AP-HM). During this period, all consecutive outpatients 70 years or older referred for a CGA before initiation of lung cancer treatment were enrolled. The objective of this study was to compare lung and thoracic cancer management of octogenarians (≥80 years) and their geriatric profile versus patients aged 70 to 79 years (<80 years). FINDINGS: In our study, 228 patients were recruited. The median age was 78.7 ± 5 years. There were 94 octogenarians (41.2%), 36.2% of them were diagnosed with stage IV neoplasm and the most common treatment was chemotherapy (43.6%). The logistic regression analysis highlights that handgrip strength was the most commonly impaired domain (OR 2.3; 95% CI [1.3-4.3]) in octogenarians and that they are more likely than their younger counterparts to be treated by targeted therapy (OR 9.8; 95% CI [1.0-92.9]). Overall survival (OS) was similar in both age groups (log rank = 0,95). INTERPRETATION: In our study, octogenarians and patients <80 years had equivalent survival, across the different thoracic cancer treatments and tumor stages. Measure of muscle strength in CGA could be very useful in a clinical setting to help improve the management of older old patients treated for lung or thoracic cancer.
Authors: Carolyn J Presley; Mostafa R Mohamed; Eva Culakova; Marie Flannery; Pooja H Vibhakar; Rebecca Hoyd; Arya Amini; Noam VanderWalde; Melisa L Wong; Yukari Tsubata; Daniel J Spakowicz; Supriya G Mohile Journal: Front Oncol Date: 2022-03-31 Impact factor: 5.738