Development of a predictor of one-year mortality in older patients with cancer by geriatric and oncologic parameters

Chiara Giannotti, Gabriele Zoppoli, Lorenzo Ferrando, Roberto Murialdo, Irene Caffa, Alice Laudisio, Stefano Scabini, Emanuele Romairone, Piero Fregatti, Daniele Friedman, Patrizio Odetti, Alessio Nencioni, Alberto Ballestrero, Fiammetta Monacelli

Research output: Contribution to journalArticle

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 languageEnglish
JournalJournal of Geriatric Oncology
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Geriatrics
Mortality
Geriatric Assessment
Neoplasms
Nutrition Assessment
Area Under Curve
Colorectal Neoplasms
Prospective Studies
Breast Neoplasms
Population
Oncologists

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 journalArticle

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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{\circledR}) 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{\circledR} showed high specificity (0.86) and AUC = 0.71 (95{\%} CI = 0.55–0.87). Conclusions: MetaGENUA{\circledR} predicts one-year mortality in older patients with cancer with high specificity. As such, MetaGENUA{\circledR} is predicted to reveal as a useful tool to guide the oncologist's decisions in clinical practice.",
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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

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