title: Prognostic value of geriatric assessment in older patients with advanced breast cancer receiving chemotherapy.
abstract: BACKGROUND
  The prognostic value of geriatric assessment in older patients with breast cancer treated with chemotherapy is largely unknown.
  
  
  METHODS
  Fifty-five patients with advanced breast cancer aged 70 years or older were assessed by Mini Nutritional Assessment (MNA), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Groningen Frailty Indicator (GFI) and Mini Mental State Examination (MMSE). Levels of albumin, hemoglobin, creatinine and lactate dehydrogenase were measured. Patients completing at least four cycles of chemotherapy were reassessed by GFI and MMSE and mortality was evaluated using Cox regression analysis.
  
  
  RESULTS
  The mean age was 76 year (SD 4.8). Inferior MNA and GFI scores were associated with increased hazard ratios for mortality: 3.05 (95% confidence interval [CI]: 1.44-6.45; p = 0.004) and 3.40 (95% CI: 1.62-7.10; p = 0.001), respectively. Physical aspects of frailty worsened during the course of chemotherapy. Laboratory values were not associated with assessment scores nor were they predictive for mortality.
  
  
  CONCLUSIONS
  Malnutrition and frailty, rather than cognitive impairment and laboratory values, were associated with an increased mortality risk in these elderly breast cancer patients with advanced breast cancer.
authors: Institute of Mental Health, Bouman GGZ, Rotterdam, The Netherlands. Electronic address: a.aaldriks@telfort.nl.
authors: A A
authors: AA
authors: Aaldriks
authors: E J
authors: EJ
authors: Giltay
authors: S
authors: S
authors: le Cessie
authors: L G M
authors: LG
authors: van der Geest
authors: J E A
authors: JE
authors: Portielje
authors: B C
authors: BC
authors: Tanis
authors: J W R
authors: JW
authors: Nortier
authors: E
authors: E
authors: Maartense
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D018567:Breast Neoplasms, Male / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D003072:Cognition Disorders / Q000150:complications; D003404:Creatinine / Q000097:blood; D005260:Female; D015577:Geriatric Assessment; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D044342:Malnutrition / Q000150:complications; D011379:Prognosis; D016016:Proportional Hazards Models; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D000970:Antineoplastic Agents; D006454:Hemoglobins; D012709:Serum Albumin; D003404:Creatinine; D007770:L-Lactate Dehydrogenase
keywords: Breast cancer; Chemotherapy; Elderly; Geriatric assessment