Use of a simplified geriatric evaluation in thoracic oncology.
Management of elderly patients with bronchial cancer should take into account specific factors linked to the patient's age, and the presence of co-morbidities. A geriatric evaluation enables us to use relevant information in the therapeutic decision-making process. However, the Comprehensive Geriatric Assessment described in the literature is tedious and time-consuming. We describe the use of a simplified geriatric evaluation (SGE), in 57 patients aged >/=75 years (mean age: 80.8 years) with thoracic cancer, before discussing therapeutic options with colleagues from various departments. This evaluation enabled us to classify the patients into four groups: group 1 consisted of patients in a good general state; group 2+ comprised patients with no more than two stabilized co-morbidities or one poorly or non-stabilized co-morbidity; group 2- comprised patients with more than two stabilized co-morbidities, or at least two poorly or non-stabilized co-morbidities; group 3 consisted of frail patients. The three patients in group 1 did not have any negative factors that could complicate their management and therefore received anti-tumor therapy. The 15 patients in group 3 were considered to have co-morbidities or functional alterations that were too advanced for them to benefit from anti-tumor therapy, and received symptomatic treatment only. Among the 39 patients in the intermediary groups 2+ and 2-, 24 underwent surgery, chemotherapy or radiotherapy (21 (87.5%) patients in group 2+ and 3 (20.0%) patients in group 2-). These data suggest that the SGE is an important aid to decision-making in the management of elderly patients with bronchial cancer.
Cudennec
Tristan
T
Service de Médecine Gériatrique, CHU Ambroise Paré, Assistance Publique - Hôpitaux de Paris, UFR Médicale, Université Versailles Saint Quentin, Paris, France.
Gendry
Thierry
T
Labrune
Sylvie
S
Giraud
Violaine
V
Moulias
Sophie
S
Teillet
Laurent
L
Chinet
Thierry
T
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006305:Health Status Indicators; D006801:Humans; D008175:Lung Neoplasms / Q000145:classification* / Q000453:epidemiology / Q000628:therapy; D008297:Male