Comprehensive geriatric assessment in elderly cancer patients: an experience in an outpatient population.
OBJECTIVE
Cancer is an age-related disease, and the increase in life expectancy will lead to a progressive increase of cancer cases in the elderly (> or =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.


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, > or =3 comorbidities unrelated to the tumor according to the Charlson Index, performance status < or =60/> or =3 according respectively to Karnofsky and the ECOG scale, > or =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 randomized studies with a larger number of patients, also in an adjuvant setting, should be performed to confirm the effectiveness of this approach.
Arnoldi
Ermenegildo
E
Oncology Department, Ospedali Riuniti, Bergamo, Italy. earnoldi@ospedaliriuniti.bergamo.it
Dieli
Maria
M
Mangia
Marina
M
Minetti
Bruno
B
Labianca
Roberto
R
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D005853:Geriatrics / Q000592:standards*; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D010045:Outpatients; D012307:Risk Factors