Does the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), predict mortality in cancer patients? Results of a prospective observational trial.
OBJECTIVE
Despite the lack of definitive data on the impact of Comprehensive Geriatric Assessment (CGA) in the geriatric oncology setting, the broad use of any form of CGA is strongly recommended before any treatment decision in elderly cancer patients (ECP); currently there is no consensus about the best format for this geriatric assessment. The aim of this study was to firstly test the Multidimensional Prognostic Index (MPI) in ECP with locally advanced or metastatic disease.


METHODS
Patients aged ≥70years with inoperable or metastatic solid cancer consecutively admitted to our Program of Geriatric Oncology were assessed by a multidisciplinary team and received a basal CGA to calculate the MPI score.


RESULTS
A hundred and sixty patients entered the study. In the Cox's regression model, MPI, CIRS-SI, BSA, GDS, MMSE, chemotherapy and a diagnosis of primary lung cancer were associated with mortality at 6 and 12months. The ROC curves confirmed the prognostic value of MPI, with the best discriminatory power for mortality at both 6 and 12months.


CONCLUSIONS
The present study is the first to indicate that the MPI retains its prognostic value even in elderly cancer patients with advanced stage of disease. The CIRS-SI and the GDS may potentiate the prognostic value of MPI.
Geriatric Clinic, Department of Medical Science, University of Padova, Via Giustininani 2, 35128 Padova, Italy.
Valter
V
Giantin
Elisabetta
E
Valentini
Mario
M
Iasevoli
Cristina
C
Falci
Paola
P
Siviero
Elisabetta
E
De Luca
Stefania
S
Maggi
Bruno
B
Martella
Graziella
G
Orrù
Gaetano
G
Crepaldi
Silvio
S
Monfardini
Oreste
O
Terranova
Enzo
E
Manzato
D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution