Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG).
BACKGROUND
As more and more cancers occur in elderly people, oncologists are increasingly confronted with the necessity of integrating geriatric parameters in the treatment of their patients.


METHODS
The International Society of Geriatric Oncology (SIOG) created a task force to review the evidence on the use of a comprehensive geriatric assessment (CGA) in cancer patients. A systematic review of the evidence was conducted.


RESULTS
Several biological and clinical correlates of aging have been identified. Their relative weight and clinical usefulness is still poorly defined. There is strong evidence that a CGA detects many problems missed by a regular assessment in general geriatric and in cancer patients. There is also strong evidence that a CGA improves function and reduces hospitalization in the elderly. There is heterogeneous evidence that it improves survival and that it is cost-effective. There is corroborative evidence from a few studies conducted in cancer patients. Screening tools exist and were successfully used in settings such as the emergency room, but globally were poorly tested. The article contains recommendations for the use of CGA in research and clinical care for older cancer patients.


CONCLUSIONS
A CGA, with or without screening, and with follow-up, should be used in older cancer patients, in order to detect unaddressed problems, improve their functional status, and possibly their survival. The task force cannot recommend any specific tool or approach above others at this point and general geriatric experience should be used.
Extermann
Martine
M
H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA. extermann@moffitt.usf.edu
Aapro
Matti
M
Bernabei
Roberto
R
Cohen
Harvey Jay
HJ
Droz
Jean-Pierre
JP
Lichtman
Stuart
S
Mor
Vincent
V
Monfardini
Silvio
S
Repetto
Lazzaro
L
Sørbye
Liv
L
Topinkova
Eva
E
D026683:Advisory Committees; D000368:Aged; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D005853:Geriatrics / Q000639:trends; D006287:Health Planning Guidelines; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000639:trends; D012955:Societies, Medical / Q000639:trends