Prognosis Of Elderly Cancer Patients Research Articles

A digital self-reported G8 screening tool: A comparison study

Background Geriatric assessment (GA) has been shown to be pivotal to the prognosis of elderly cancer patients. A G8 screening tool could act as a potential surrogate to identify patients who would benefit from further GA in a busy oncology clinic and a digital version would allow for a wider application. Objectives To develop a digital self-reported version of G8, and to compare its outcomes with in-person G8 administered by a healthcare professional. Methods A total of 483 cancer patients aged 70 years and older who received an in-person G8 assessment at the National Cancer Centre Singapore (NCCS) clinic, and another 544 who completed the digital self-reported G8 were analysed. Total G8 score ≤14 was defined as positive screen. Results Response rate of the digital self-reported G8 was 50%. Median G8 total score was lower among online screeners than in-person screeners (11 vs 12.5, p < 0.001). The odds of a G8 positive screen among online screeners was higher than that of in-person screeners on multivariable logistic regression analysis (odds ratio = 1.56, 95% CI 1.08-2.26). Some 20 in-person screeners had also completed the digital self-reported G8, and the agreement between their in-person and online G8 total scores was high (concordance correlation coefficient = 0.798, 95% CI 0.635-0.962). Conclusions A digital self-reported G8 is feasible. However, given the higher positive screen rate among the online screeners, replacement of the in-person G8 with the digital self-reported G8 should be implemented only after more conclusive evidence on the agreement between in-person and online G8 score is available.

Prognostic analysis of 102 elderly cancer patients with brain metastases

Objective To explore the related factors for the prognosis in elderly cancer patients with cerebral metastases, to study the adaptability of brain metastasis in recursive partitioning analysis(RPA)and the prognosis Assessment (GPA) Scale, in order to provide the basis for the prognosis assessment and treatment in the elderly patients with brain metastasis. Methods A retrospective analysis was studied in 102 elderly cancer patients with brain metastasis (aged 60 years and over) with complete follow-up data in our hospital from January 2005 to January 2012. Survival analysis was performed by using the Kaplan-Meier method. Univariate analysis of ethnicity, age, Karnofsky score, gender, smoking, primary tumor origin, the number of intracranial metastatic tumor, intracranial and extracranial metastasis, the efficacy of treatment for primary tumor, the treatment of brain metastases were analyzed by Log-rank test. Results The median survival time was 6 months. The 6-month and 12- month survival rates were 54.90% and 16.67% respectively. Univariate analysis showed that Karnofsky score, smoking, the number of intracranial metastatic tumor, time to diagnosis and treatment, the efficacy of treatment for primary tumor and other underlying diseases were the relative factors for prognosis of elderly cancer patients with brain metastases (χ2= 20.828, 5.737, 7.395, 5.379, 11.556, 6.844, all P<0.05). Cox multivariate regression analysis showed that the Karnofsky score, the number of intracranial metastatic tumor, the efficacy of treatment for primary tumor and other underlying diseases were the independent prognostic factors (all P<0.05). The median survival periods in RPA class Ⅰ, Ⅱ, Ⅲ were 11, 7, 4 month respectively (χ2=27.358, P<0.001). The median survival periods in GPA classⅠ, Ⅱ, Ⅲ-Ⅳ were 5, 8, 13 months respectively (χ2=29.570, P<0.001). Conclusions Karnofsky score, the number of intracranial metastatic tumor, the efficacy of treatment for primary tumor and other underlying diseases are the independent factors for the prognosis in elderly cancer patients with cerebral metastases. RPA and GPA classification have a good adaptability in elderly patients with brain metastases. Key words: Neoplasm metastasis; Brain Prognosis

Continuous comprehensive geriatric assessment could predict the prognosis in elderly cancer patients

Continuous comprehensive geriatric assessment could predict the prognosis in elderly cancer patients