Cumulative deficit model of geriatric assessment to predict the postoperative outcomes of older patients with solid abdominal cancer. Abridged geriatric assessment is a better predictor of overall survival than the Karnofsky Performance Scale and Physical Performance Test in elderly patients with cancer. Geriatric assessment in elderly patients with prostate cancer. The feasibility of inpatient geriatric assessment for older adults receiving induction chemotherapy for acute myelogenous leukemia. Role of geriatric intervention in the treatment of older patients with cancer: rationale and design of a phase III multicenter trial Screening for frailty among older patients with cancer that qualify for abdominal surgery. Comprehensive geriatric assessment and comorbidities predict survival in geriatric oncology Identifying vulnerable older adults with cancer: integrating geriatric assessment into oncology practice. Comprehensive Geriatric Assessment in Elderly Cancer Patients: An Experience in an Outpatient Population Geriatric screening results and the association with severe treatment toxicity after the first cycle of (radio)chemotherapy. Improving the quality of life of geriatric cancer patients with a structured multidisciplinary intervention: a randomized controlled trial. A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. Evaluation of geriatric assessment in patients with chronic lymphocytic leukemia: Results of the CLL9 trial of the German CLL study group Characteristics and treatment options of elderly Chinese patients with cancer as determined by Comprehensive Geriatric Assessment (CGA). Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Primary central nervous system lymphoma: the Memorial Sloan-Kettering Cancer Center prognostic model. Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia.
OBJECTIVE The geriatric assessment ( GA ) has proven to be of great value for clinicians treating older patients . However , a clear consensus on the optimal set of GA instruments is lacking , particularly for surgical patients . Therefore , the aim of this prospect i ve study was to compare the prevalence of frailty , depending on the number of incorporated GA domains , and to evaluate its accuracy in predicting postoperative outcome . MATERIAL S AND METHODS Seventy-five patients aged 65 years and older , qualified for abdominal surgery due to solid cancer , were enrolled . The GA included a wide variety of vali date d tools that evaluate functional , mobility , nutritional , co-morbidity , polypharmacy , and psychosocial domains .  RESULTS Depending on the number of incorporated GA domains the frequency of frailty was 23 - 97 % . The cumulative score rather than individual components of the GA , turned out to be an independent risk factor of 30-day postoperative morbidity . In predicting 30-day " any " and " major " morbidities , the area under the curve was 0.67 - 0.72 and 0.70 - 0.82 ( model including the severity of the surgery ) vs. 0.57 - 0.66 and 0.50 - 0.65 ( model not including the severity of the surgery ) , respectively . CONCLUSION The number of incorporated GA domains has a great influence on the prevalence of frailty and on adequate surgical risk assessment . The summary deficit score based on Pre-operative Assessment of Cancer in the Elderly ( PACE ) or the GA consisting of functional , mobility , cognitive , depression , nutritional , co-morbidity , polypharmacy , and social support assessment domains can predict 30-day postoperative morbidity . However , only models with addition of the severity of surgery show moderate to good predictive value OBJECTIVES Comprehensive geriatric assessment ( CGA ) is a complex and interdisciplinary approach to evaluate the health status of elderly patients . The Karnofsky Performance Scale ( KPS ) and Physical Performance Test ( PPT ) are less time-consuming tools that measure functional status . This study was design ed to assess and compare abridged geriatric assessment ( GA ) , KPS and PPT as predictive tools of mortality in elderly patients with cancer . MATERIAL S AND METHODS This prospect i ve interventional study included all individuals aged > 70years who were diagnosed with cancer during the study period . Subjects were interviewed directly using a procedure that included a clinical test and a question naire composed of the KPS , PPT and abridged GCA .  Overall survival ( OS ) was the primary endpoint . The log rank test was used to compare survival curves , and Cox 's regression model ( forward procedure ) was used for multivariate survival analysis . RESULTS One hundred patients were included in this study . Abridged GA was the only tool found to predict mortality [ median OS for unfit patients ( at least two impairments ) 467days vs 1030days for fit patients ; p=0.04 ] . Patients defined as fit by mean PPT score ( > 20 ) had worse median OS ( 560 vs 721days ) ; however , this difference was not significant ( p=0.488 on log rank ) . Although median OS did not differ significantly between patients with low ( ≤80 ) and high ( > 80 ) KPS scores ( 467 and 795days , respectively ; p=0.09 ) , survival curves diverged after nearly 120days of follow-up . Visual and hearing impairments were the only components of abridged GA of prognostic value . CONCLUSION Neither KPS nor PPT were shown to predict mortality in elderly patients with cancer whereas abridged GA was predictive . This study suggests a possible role for visual and hearing assessment as screening for patients requiring CGA As a result of demographic evolution , oncologists will treat more and more elderly patients with prostate cancer . Aging is frequently associated with the coexistence of several medical complications that can increase the complexity of cancer treatment decision-making . Unfortunately , clinical oncologists need to be more familiar with the multidimensional assessment of elderly patients . To acquire this skill , we implemented a multidimensional geriatric assessment program at our cancer center . This instrument prospect ively assessed 60 elderly patients with prostate cancer . Herein , we describe geriatric aspects detected in our patient sample and report treatment options proposed to elderly patients with prostate cancer at different disease stages . The minimal comprehensive geriatric assessment ( mini-CGA ) procedure revealed that 66 % of our patient population was dependent in one or more of the Katz Activities of Daily Living and 87 % were dependent in 1 or more of the Lawton Instrumental Activities of Daily Living ; all patients had significant comorbidity according to the Cumulative Illness Rating Scale-Geriatrics  , 75 % having at least one severe comorbidity . We identified 19 cases of drug interaction . We also observed that half of these patients had a risk of falling and some physical disability ; 45 % had cognitive disorders requiring more investigation ; one third had depressive symptoms . Finally , 65 % of the patients were either malnourished or at risk of malnutrition . Many of these problems were unknown before the mini-CGA processing and may interfere with cancer and cancer treatment . Thus , the correct management of elderly patients with cancer requires comprehensive geriatric assessment as well as relevant disease staging at diagnosis . This approach will help us to propose the most appropriate treatment with the main aim of preserving quality of life OBJECTIVES To test the feasibility and utility of a bedside geriatric assessment ( GA ) to detect impairment in multiple geriatric domains in older adults initiating chemotherapy for acute myelogenous leukemia ( AML ) . DESIGN Prospect i ve observational cohort study . SETTING Single academic institution . PARTICIPANTS Individuals aged 60 and older with newly diagnosed AML and planned chemotherapy . MEASUREMENTS Bedside GA was performed during inpatient exmination for AML . GA measures included the modified Mini-Mental State Examination ; Center for Epidemiologic Studies Depression Scale ; Distress Thermometer , Pepper Assessment Tool for Disability ( includes self- reported activities of daily living ( ADLs ) , instrumental ADLs , and mobility questions ) ; Short Physical Performance Battery ( includes timed 4-m walk , chair st and s , st and ing balance ) ; grip strength , and Hematopoietic Cell Transplantation Comorbidity Index . RESULTS Of 54 participants ( mean age 70.8 ± 6.4 ) eligible for this analysis , 92.6 % completed the entire GA battery ( mean time 44.0 ± 14 minutes ) . The following impairments were detected : cognitive impairment , 31.5 % ; depression , 38.9 % ; distress , 53.7 % ; impairment in ADLs , 48.2 % ; impaired physical performance , 53.7 % ; and comorbidity , 46.3 % . Most were impaired in one ( 92.6 % ) or more ( 63 % ) functional domains . For the 38 participants rated as having good performance status according to st and ard oncologic assessment ( Eastern Cooperative Oncology Performance Scale score ≤1 ) , impairments in individual GA measures ranged from 23.7 % to 50 % . Significant variability in cognitive , emotional , and physical status was detected even after stratification according to tumor biology ( cytogenetic risk group classification ) . CONCLUSION Inpatient GA was feasible and added new information to st and ard oncology assessment , which may be important for stratifying therapeutic risk in older adults with AML Background In the general geriatric population , programs linking geriatric evaluation with interventions are effective for improving functional status and survival of the patients . Whether or not these interventions improve health related quality of life ( HRQoL ) or overall survival ( OS ) in older patients with cancer is not yet clear . Indeed , r and omized data on the effect of such interventions on survival and HRQoL are rare and conflicting . We describe the rationale and design of a phase III multicenter trial aim ed at assessing the efficacy of geriatric intervention in the management of elderly patients with cancer . Methods / design Approximately 1200 patients , 70 years and older , considered in need of a geriatric intervention based on the G8 screening tool will be r and omized into two intervention arms . The ‘ Usual-care ’ arm involves st and ard oncological care based on pre-defined oncological protocol s. In addition to the st and ard oncological care , the ‘ Case-management ’ arm involves a multidimensional geriatric assessment and interventions tailored for the patient . Efficacy will be assessed using a co- primary endpoint encompassing OS and HRQoL. Discussion This trial has been design ed to assess whether focused geriatric case management can either improve OS or HRQoL in elderly cancer patients considered in need of geriatric assessment .Trial registration Clinical trials.gov ID : NCT02704832 OBJECTIVE The Geriatric Assessment ( GA ) is an established method for evaluating and optimizing diagnostic and treatment plans . However , it requires experience and is time-consuming . Therefore , a variety of screening methods have been developed . The aim of this study was to compare their accuracy for predicting frailty among older patients with cancer qualified for abdominal surgery based on comparison to the GA . MATERIAL AND METHODS One hundred and thirty five consecutive patients ≥65years of age were prospect ively enrolled . The diagnostic performance of eight screening tests was evaluated : The Vulnerable Elderly Survey ( VES-13 ) , Triage Risk Screening Tool ( TRST ) , Geriatric 8 ( G8 ) , Groningen Frailty Index ( GFI ) , abbreviated Comprehensive Geriatric Assessment ( aCGA ) , Rockwood , Balducci and Fried score . RESULTS The prevalence of frailty as diagnosed by the GA was 73 % . Screening methods identified frail patients in 40 - 75.5 % of cases . The sensitivity and specificity of these tests in predicting frailty were 52%-97 % ( Fried score-G8 ) and 44 - 100 % ( G8-Rockwood score ) , respectively . The positive and negative predictive values were 82 - 100 % ( Balducci-Rockwood ) and 43 - 84 % ( TRST-G8 ) , respectively . Age significantly influenced the predictive value of the screening tests whereas gender and type of cancer did not . CONCLUSION At present , there is no universal screening test that adequately identifies frailty in at risk older patients . The results of this study showed that the aCGA and G8 were the best screens for older patients with cancer that qualified for elective abdominal surgery ; the G8 had the highest sensitivity and negative predictive value and the aCGA was a good overall assessment tool Objectives : The comprehensive geriatric assessment ( CGA ) can detect geriatric problems and potentially improve survival , physical , and cognitive state of patients , as well as increase an older person ’s chances of staying at home longer . In older people , the number and severity of comorbidity increase with age and are an important determinant of survival . The aim of the study was to assess to which extent CGA and comorbidities could be seen as determinants of survival . Material s and methods : This study analyzed data from two hospitals that included geriatric assessment s of patients aged 70 years and more with cancer linked to mortality .  Logistic regression was used to model survival predictors . Results : Two hundred and five various cancer patients ( 47 % females ) with a median age of 79 were included . They presented with a lot of undiagnosed geriatric problems . Screening scales ( G8 , SEGA ) , cognitive , and psychological disorders , and low albumin levels appeared to be independent survival factors . A frailty profile classification was associated with higher mortality . The average comorbidity was grade d 2 according to the Charlson scale . By the geriatric cumulative illness rating scale ( CIRS-G ) , the arithmetic average number of affected organ systems was 5 ( range 0–10 ) in all patients . Cardiovascular disorders were the most common comorbidity . Renal insufficiency and anaemia were negatively associated with survival . Conclusion : Old cancer patients present a lot of comorbidities and newly diagnosed geriatric problems . Several tools provide determinants of survival in old cancer patients . Prospect i ve trials evaluating the utility of a CGA to guide interventions to improve quality of cancer care in older adults are justified OBJECTIVES To integrate the principles of geriatric assessment into the care of older patients with cancer in order to identify vulnerable older adults and develop interventions to optimize cancer treatment . DESIGN A brief , comprehensive , self-administered question naire and intervention algorithm were developed consisting of measures of  geriatric assessment  that are brief , reliable , vali date d , and predictive of mortality and morbidity in older patients . SETTING Academic tertiary care cancer center and community-based satellite practice . PARTICIPANTS Patients aged 65 and older with cancer . MEASUREMENTS The question naire solicits information about the patient 's functional status , comorbidity , psychological status , nutritional status , and social support . A scoring algorithm for referral to a multidisciplinary team was developed . RESULTS Two hundred forty-five of 250 patients completed the question naire ( mean age 76 , range 65 - 95 ) . The majority of patients were women ( 71 % ) , white ( 95 % ) , married ( 52 % ) , and retired ( 90 % ) , with a variety of tumor types and stages . Most patients ( 78 % ) completed the question naire on their own and reported acceptance of question naire length ( 91 % ) , no difficult questions ( 94 % ) , no up setting questions ( 96 % ) , and no missing questions ( 89 % ) . The mean time to completion was 15 minutes , with a median of 12.5 ( st and ard deviation 10 , range 2 - 60 ) . Information from this question naire helped identify physical and psychological impairments , poor nutrition , lack of social support , and untreated comorbidities . Appropriate referrals to a multidisciplinary team were made . CONCLUSION This brief , comprehensive , self-administered question naire is feasible for use in the outpatient oncology setting and helped identify the needs of geriatric oncology patients . Prospect i ve trials are needed to determine the effectiveness of the interventions offered Aims and background Cancer is an age-related disease , and the increase in life expectancy will lead to a progressive increase of cancer cases in the elderly ( ≥70 years of age ) . We have created a group called GONG ( Gruppo Oncologico Geriatrico ) to apply cancer geriatric assessment in elderly cancer patients , in order to select which of them are eligible for oncological treatment or supportive care only . Patients and methods We applied this model to evaluate 153 patients from March 2004 to August 2005 . Our model included three categories of patients : frail ( at least one of the following items : Activities of Daily Living scale < 80 , ≥3 comorbidities unrelated to the tumor according to the Charlson Index , performance status ≤60/≥3 according respectively to Karnofsky and the ECOG scale , ≥1 geriatric syndrome ) ; borderline ( patients with multiple comorbidities not affecting performance status or ability in daily activities ) ; non-frail . Results Applying the aforementioned criteria , we found 30 borderline , 14 frail and 109 non-frail patients . Statistical analysis showed a significant difference in mortality between frail and non-frail patients ( P < 0.05 ) , whereas there was no difference between borderline and non-frail patients . Conclusions Our model was thus able to identify patients at higher risk of death . These results confirm the importance of cancer geriatric assessment also for the clinical evaluation of oncological patients . Additional r and omized studies with a larger number of patients , also in an adjuvant setting , should be performed to confirm the effectiveness of this approach BACKGROUND Screening tools are used in geriatric oncology to determine who should receive a Comprehensive Geriatric Assessment ( CGA ) . However , in this prospect i ve study , we evaluated the association between geriatric screening results , measured with the G8 and Groningen Frailty Indicator ( GFI ) , and severe treatment toxicity . METHODS Patients over 65 years with various types and stages of cancer were screened with the G8 and the GFI prior to the start of treatment . The association between geriatric screening results and Serious Adverse Events ( SAE ) after the first cycle of (radio)chemotherapy were studied with bivariate analysis ( normal versus abnormal screening test ) and logistic regression analysis . RESULTS From 170 screened patients , 85 patients were eligible for this study . The median age was 76 years ( range : 66 - 88 years ) . The treatment intent was curative in 46 % and palliative in 54 % . A SAE occurred in 15 patients ( 18 % ) of which three result ed in death . There was no significant association between the G8 , as a dichotomous predictor ( p = 0.376 ) or as a continuous predictor ( p = 0.298 ) , and risk of a SAE . We also found no significant association for the GFI analysed as a dichotomous predictor ( cut-off ≥4 : p = 0.384 ; cut-off ≥3 : p = 0.773 ) , nor as a continuous predictor ( p = 0.734 ) . All associations remained insignificant when adjusted for treatment type and comorbidity . CONCLUSION The G8 and the GFI can be used to select patients for CGA , but they do not seem to be predictive for short-term severe treatment toxicity OBJECTIVE To examine the potential impact of elderly age on response to participation in a structured , multidisciplinary quality -of-life ( QOL ) intervention for patients with advanced cancer undergoing radiation therapy .  METHODS Study design was a r and omized stratified , two group , controlled clinical trial in the setting of a tertiary care comprehensive cancer center . Subjects with newly diagnosed cancer and an estimated 5-year survival rate of 0%-50 % who required radiation therapy  were recruited and r and omly assigned to either an intervention group or a st and ard care group . The intervention consisted of eight 90-min sessions design ed to address the five QOL domains of cognitive , physical , emotional , spiritual , and social functioning . QOL was measured using Spitzer uniscale and linear analogue self- assessment ( LASA ) at baseline and weeks 4 , 8 , and 27 . RESULTS Of the 103 study participants , 33 were geriatric ( 65 years or older ) , of which 16 ( mean age 72.4 years ) received the intervention and 17 ( mean age 71.4 years ) were assigned to the st and ard medical care . The geriatric participants who completed the intervention had higher QOL scores at baseline , at week 4 and at week 8 , compared to the control participants . SIGNIFICANCE OF RESULTS Our results demonstrate that geriatric patients with advanced cancer undergoing radiation therapy will benefit from participation in a structured multidisciplinary QOL intervention . Therefore , geriatric individuals should not be excluded from participating in a cancer QOL intervention , and , in fact , elderly age may be an indicator of strong response to a QOL intervention . Future research should further explore this finding UNLABELLED Studies of comprehensive geriatric assessment ( CGA ) have shown the importance of follow-up for effectiveness , but this has not been tested in an oncology clinic . In this pilot study , we enrolled 15 early breast cancer patients , aged 70 and older . They received a multidisciplinary CGA every 3 months and structured follow-up from the SAOP nurse practitioner , dietitian , social worker , and pharmacist according to risk . Total follow-up was 6 months . Median age of evaluable patients was 79 years ( range 72 - 87 ) .  Median number of comorbidities by Cumulative Index Rating Scale-Geriatric ( CIRS-G ) was 5 ( 3 - 9 ) at baseline . Ten patients were at pharmacological risk , five at psychosocial risk , and eight at nutritional risk . Patients presented on average six problems initially , and three new problems during follow-up . The intervention directly influenced oncological treatment in four cases . It ensured continuity/coordination of care in seven cases . Success rate in addressing problems was 87 % . Mean Functional Assessment of Cancer Treatment-Breast ( FACT-B ) scores improved from 110.5 ( S.D. 16.7 ) to 116.3 ( S.D. 16.5 ) ( t=0.025 ) . Function and independence were maintained . CONCLUSIONS Older patients with early breast cancer have a high prevalence of comorbidity . A CGA with follow-up has potential for improving the treatment and prognosis of these patients and is feasible in an academic oncology setting Abstract Multidimensional geriatric assessment ( GA ) has been demonstrated to predict outcomes in older patients with cancer . This study evaluated GA in a cohort of older patients with chronic lymphocytic leukemia ( CLL ) . Seventy-five of 97 subjects with CLL who were enrolled in a clinical trial of the German CLL Study Group underwent GA prior to the start of study treatment ( low-dose chemotherapy with fludarabine ) . GA included  cumulative illness rating scale ( CIRS ) , timed-up- and -go ( TUG ) test , dementia detection ( DEMTECT ) test and instrumental activities of daily living ( IADL ) index . There was little correlation between CIRS , TUG , DEMTECT or IADL results and treatment toxicity , feasibility or efficacy in this study . CIRS and IADL had no statistically significant impact on overall prognosis . However , under-performance in TUG or DEMTECT test was strongly associated with poor survival . The latter findings provide a rationale to further investigate geriatric  assessment in CLL and in the context with other CLL treatments OBJECTIVE China is experiencing a rapid increase in cancer incidence in elderly patients . In order to better underst and this group , a large study of patients from multiple tertiary centers in the Beijing area was design ed . This study was design ed to provide insight into their unique treatment preferences , including the use of traditional Chinese medicine ( TCM ) . MATERIAL S AND METHODS 803 patients from nine hospitals in the Beijing area were enrolled into this study . The inclusion criteria were patients who were 65 years or older and had a diagnosis of cancer at any stage . The CGA question naire used with these patients included the Chinese translation of the Gero-Oncology Health and Quality of Life Assessment tool . The question naire was provided to patients by a research nurse and was administered in M and arin . RESULTS The mean age of the patients was 72 years ( range 65 - 94 ) . The patients were mainly male ( 59.8 % ) and of Han ethnicity ( 95.4 % ) . About 45 % of these patients also had concurrent  TCM  in addition to their other cancer treatments . About 70 % were able to manage their activities of daily living without assistance . Patients on TCM were more likely to have higher number of co-morbidities compared to their counterparts . CONCLUSION This is the largest prospect i ve study of CGA assessment s done on elderly patients with cancer in Asia . The study demonstrates that CGA provides insights into underst and ing the needs of elderly Chinese patients with cancer .  TCM is used frequently in China , and its impact on quality of life needs further investigation BACKGROUND Development of a geriatric screening tool is necessary to identify elderly cancer patients who would benefit from comprehensive geriatric assessment ( CGA ) .  We develop and evaluate the G-8 screening tool against various reference tests . PATIENTS AND METHODS Analyses were based on 364 cancer patients aged>70 years scheduled to receive first-line chemotherapy included in a multicenter prospect i ve study . The G-8 consists of seven items from the Mini Nutritional Assessment ( MNA ) question naire and age . Our primary reference test is based on a set of seven CGA scales : Activities Daily Living ( ADL ) , Instrumental ADL , MNA , Mini-Mental State Exam , Geriatric Depression Scale , Cumulative Illness Rating Scale-Geriatrics , and Timed Get Up and Go . We considered the presence of at least one question naire with an impaired score as an abnormal reference exam . Additional reference exams are also discussed . RESULTS The prevalence of being at risk varied from 60 % to 94 % according to the various definitions of the reference test . When considering the primary reference test , a cut-off value of 14 for the G-8 tool provided a good sensitivity estimate ( 85 % ) without deteriorating the specificity excessively ( 65 % ) . CONCLUSION The G-8 shows good screening properties for identifying elderly cancer patients who could benefit from CGA PURPOSE The purpose of this study was to analyze prognostic factors for patients with newly diagnosed primary CNS lymphoma ( PCNSL ) in order to establish a predictive model that could be applied to the care of patients and the design of prospect i ve clinical trials . PATIENTS AND METHODS Three hundred thirty-eight consecutive patients with newly diagnosed PCNSL seen at Memorial Sloan-Kettering Cancer Center ( MSKCC ; New York , NY ) between 1983 and 2003 were analyzed . St and ard univariate and multivariate analyses were performed . In addition , a formal cut point analysis was used to determine the most statistically significant cut point for age . Recursive partitioning analysis ( RPA ) was used to create independent prognostic classes . An external validation set obtained from three prospect i ve Radiation Therapy Oncology Group ( RTOG ) PCNSL clinical trials was used to test the RPA classification . RESULTS Age and performance status were the only variables identified on st and ard multivariate analysis . Cut point analysis of age determined that patients age < or = 50 years had significantly improved outcome compared with older patients . RPA of 282 patients identified three distinct prognostic classes : class 1 ( patients < 50 years ) , class 2 ( patients > or = 50 ; Karnofsky performance score [ KPS ] > or = 70 ) and class 3 ( patients > or = 50 ; KPS < 70 ) . These three classes significantly distinguished outcome with regard to both overall and failure-free survival . Analysis of the RTOG data set confirmed the validity of this classification . CONCLUSION The MSKCC prognostic score is a simple , statistically powerful model with universal applicability to patients with newly diagnosed PCNSL . We recommend that it be adopted for the management of newly diagnosed patients and incorporated into the design of prospect i ve clinical trials We investigated the predictive value of geriatric assessment ( GA ) on overall survival ( OS ) for older adults with acute myelogenous leukemia ( AML ) . Consecutive patients ≥ 60 years with newly diagnosed AML and planned intensive chemotherapy were enrolled at a single institution . Pretreatment GA included evaluation of cognition , depression , distress , physical function ( PF ) ( self-reported and objective ly measured ) , and comorbidity . Objective PF was assessed using the Short Physical Performance Battery ( SPPB , timed 4-m walk , chair st and s , st and ing balance ) and grip strength . Cox proportional hazards models were fit for each GA measure as a predictor of OS . Among 74 patients , the mean age was 70 years , and 78.4 % had an Eastern Cooperative Oncology Group ( ECOG ) score ≤ 1 . OS was significantly shorter for participants who screened positive for impairment in cognition and objective ly measured PF . Adjusting for age , gender , ECOG score , cytogenetic risk group , myelodysplastic syndrome , and hemoglobin , impaired cognition ( Modified Mini-Mental State Exam < 77 ) and impaired objective PF ( SPPB < 9 ) were associated with worse OS . GA methods , with a focus on cognitive and PF , improve risk stratification and may inform interventions to improve outcomes for older AML patients
All eight domains were predictive for at least one of the investigated outcomes but the results were quite variable across studies .
Physical function and nutritional status were the domains most often associated with mortality and systemic treatment-related outcomes , and the domain physical function was most often associated with postoperative complications .
Overall , this review demonstrates that the GA should minimally consist of physical function and nutritional status , when the aim is to predict patients -related outcomes of older patients with cancer , although the results are quite heterogeneous .
BACKGROUND A geriatric assessment ( GA ) is increasingly used to help guide treatment decisions in older patients with cancer .
However , there is no consensus regarding which domains should be included in the GA .
In addition , the field of geriatric oncology moves very fast and as a result many new studies have been published since the last review in 2015 .
Therefore , the objective of this systematic review is to evaluate which domains of the GA could predict patient-related treatment outcomes of older patients with cancer and thereby should be included in a GA .