Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study.
OBJECTIVE
To appraise the performance of Comprehensive Geriatric Assessment (CGA) in elderly cancer patients (> or = 65 years) and to evaluate whether it could add further information with respect to the Eastern Cooperative Oncology Group performance status (PS).


METHODS
We studied 363 elderly cancer patients (195 males, 168 females; median age, 72 years) with solid (n = 271) or hematologic (n = 92) tumors. In addition to PS, their physical function was assessed by means of the activity of daily living (ADL) and instrumental activities of daily living (IADL) scales. Comorbidities were categorized according to Satariano's index. The association between PS, comorbidity, and the items of the CGA was assessed by means of logistic regression analysis.


RESULTS
These 363 elderly cancer patients had a good functional and mental status: 74% had a good PS (ie, lower than 2), 86% were ADL-independent, and 52% were IADL-independent. Forty-one percent of patients had one or more comorbid conditions. Of the patients with a good PS, 13.0% had two or more comorbidities; 9.3% and 37.7% had ADL or IADL limitations, respectively. By multivariate analysis, elderly cancer patients who were ADL-dependent or IADL-dependent had a nearly two-fold higher probability of having an elevated Satariano's index than independent patients. A strong association emerged between PS and CGA, with a nearly five-fold increased probability of having a poor PS (ie, > or = 2) recorded in patients dependent for ADL or IADL.


CONCLUSIONS
The CGA adds substantial information on the functional assessment of elderly cancer patients, including patients with a good PS. The role of PS as unique marker of functional status needs to be reappraised among elderly cancer patients.
Repetto
Lazzaro
L
Unità Operativa Geriatria Oncologica, Istituto Nazionale di Riposo e Cura per Anziani and Unità di Oncologia, Ospedale Fatebenefratelli Isola Tiberina, Roma, Italy. l.repetto@inrca.it
Fratino
Lucia
L
Audisio
Riccardo A
RA
Venturino
Antonella
A
Gianni
Walter
W
Vercelli
Marina
M
Parodi
Stefano
S
Dal Lago
Denise
D
Gioia
Flora
F
Monfardini
Silvio
S
Aapro
Matti S
MS
Serraino
Diego
D
Zagonel
Vittorina
V
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008603:Mental Health; D009369:Neoplasms / Q000150:complications*; D012680:Sensitivity and Specificity