Abstract
Objectives: More than 60% of the new cancer diagnoses are currently made in older adults, a highly heterogeneous population. Reliable and time-saving tools to define older adults' prognosis are needed to inform the oncologist's decisions in routine clinical practice. We sought to define a multi-domain classification tool for the prediction of all-cause one-year mortality in a cohort of older adults with solid tumors. Materials and Methods: We conducted a single-centre, prospective study of patients with solid cancer aged 65 or older and with G8 score ≤ 14. All patients underwent a comprehensive geriatric assessment (CGA) before starting their surgical or medical treatment. One-year mortality was recorded. A CGA-based prediction tool of one-year mortality was developed and subsequently validated in two independent training and testing cohorts with a 70/30 split, respectively. Results: 162 patients were enrolled. Mean patient age was 78 ± 5.5 years. Forty-three percent of the patients were men. Colorectal and breast cancer were the most common diagnoses. The clinical variables selected for the development of the new classifier (MetaGENUA®) were: mini-nutritional assessment (MNA), instrumental day life activities (IADL), Cumulative Illness Rating Scale (CIRS), geriatric depression scale (GDS), age, and cancer stage. In our independent validation cohort, MetaGENUA® showed high specificity (0.86) and AUC = 0.71 (95% CI = 0.55–0.87). Conclusions: MetaGENUA® predicts one-year mortality in older patients with cancer with high specificity. As such, MetaGENUA® is predicted to reveal as a useful tool to guide the oncologist's decisions in clinical practice.
| Original language | English |
|---|---|
| Journal | Journal of Geriatric Oncology |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2019 |
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Keywords
- Breast cancer
- Colorectal cancer
- Comprehensive geriatric assessment
- Prognostic tools
- Senior patients
- Survival
ASJC Scopus subject areas
- Oncology
- Geriatrics and Gerontology
Cite this
Development of a predictor of one-year mortality in older patients with cancer by geriatric and oncologic parameters. / Giannotti, Chiara; Zoppoli, Gabriele; Ferrando, Lorenzo; Murialdo, Roberto; Caffa, Irene; Laudisio, Alice; Scabini, Stefano; Romairone, Emanuele; Fregatti, Piero; Friedman, Daniele; Odetti, Patrizio; Nencioni, Alessio; Ballestrero, Alberto; Monacelli, Fiammetta.
In: Journal of Geriatric Oncology, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Development of a predictor of one-year mortality in older patients with cancer by geriatric and oncologic parameters
AU - Giannotti, Chiara
AU - Zoppoli, Gabriele
AU - Ferrando, Lorenzo
AU - Murialdo, Roberto
AU - Caffa, Irene
AU - Laudisio, Alice
AU - Scabini, Stefano
AU - Romairone, Emanuele
AU - Fregatti, Piero
AU - Friedman, Daniele
AU - Odetti, Patrizio
AU - Nencioni, Alessio
AU - Ballestrero, Alberto
AU - Monacelli, Fiammetta
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objectives: More than 60% of the new cancer diagnoses are currently made in older adults, a highly heterogeneous population. Reliable and time-saving tools to define older adults' prognosis are needed to inform the oncologist's decisions in routine clinical practice. We sought to define a multi-domain classification tool for the prediction of all-cause one-year mortality in a cohort of older adults with solid tumors. Materials and Methods: We conducted a single-centre, prospective study of patients with solid cancer aged 65 or older and with G8 score ≤ 14. All patients underwent a comprehensive geriatric assessment (CGA) before starting their surgical or medical treatment. One-year mortality was recorded. A CGA-based prediction tool of one-year mortality was developed and subsequently validated in two independent training and testing cohorts with a 70/30 split, respectively. Results: 162 patients were enrolled. Mean patient age was 78 ± 5.5 years. Forty-three percent of the patients were men. Colorectal and breast cancer were the most common diagnoses. The clinical variables selected for the development of the new classifier (MetaGENUA®) were: mini-nutritional assessment (MNA), instrumental day life activities (IADL), Cumulative Illness Rating Scale (CIRS), geriatric depression scale (GDS), age, and cancer stage. In our independent validation cohort, MetaGENUA® showed high specificity (0.86) and AUC = 0.71 (95% CI = 0.55–0.87). Conclusions: MetaGENUA® predicts one-year mortality in older patients with cancer with high specificity. As such, MetaGENUA® is predicted to reveal as a useful tool to guide the oncologist's decisions in clinical practice.
AB - Objectives: More than 60% of the new cancer diagnoses are currently made in older adults, a highly heterogeneous population. Reliable and time-saving tools to define older adults' prognosis are needed to inform the oncologist's decisions in routine clinical practice. We sought to define a multi-domain classification tool for the prediction of all-cause one-year mortality in a cohort of older adults with solid tumors. Materials and Methods: We conducted a single-centre, prospective study of patients with solid cancer aged 65 or older and with G8 score ≤ 14. All patients underwent a comprehensive geriatric assessment (CGA) before starting their surgical or medical treatment. One-year mortality was recorded. A CGA-based prediction tool of one-year mortality was developed and subsequently validated in two independent training and testing cohorts with a 70/30 split, respectively. Results: 162 patients were enrolled. Mean patient age was 78 ± 5.5 years. Forty-three percent of the patients were men. Colorectal and breast cancer were the most common diagnoses. The clinical variables selected for the development of the new classifier (MetaGENUA®) were: mini-nutritional assessment (MNA), instrumental day life activities (IADL), Cumulative Illness Rating Scale (CIRS), geriatric depression scale (GDS), age, and cancer stage. In our independent validation cohort, MetaGENUA® showed high specificity (0.86) and AUC = 0.71 (95% CI = 0.55–0.87). Conclusions: MetaGENUA® predicts one-year mortality in older patients with cancer with high specificity. As such, MetaGENUA® is predicted to reveal as a useful tool to guide the oncologist's decisions in clinical practice.
KW - Breast cancer
KW - Colorectal cancer
KW - Comprehensive geriatric assessment
KW - Prognostic tools
KW - Senior patients
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85075465036&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075465036&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2019.10.018
DO - 10.1016/j.jgo.2019.10.018
M3 - Article
C2 - 31706829
AN - SCOPUS:85075465036
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
SN - 1879-4068
ER -