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 journalArticlepeer-review

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

Keywords

  • Breast cancer
  • Colorectal cancer
  • Comprehensive geriatric assessment
  • Prognostic tools
  • Senior patients
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Geriatrics and Gerontology

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