Experience of multidisciplinary assessment of elderly patients with cancer in a French general hospital during 1 year: a new model care study.
OBJECTIVE
Our main aim was to describe and explore a multidisciplinary approach to the management of elderly patients with cancer, who constitute a heterogeneous population.


METHODS
This descriptive study was performed between October 2009 and September 2010. Patients with cancer ≥ 70 years of age were included. Some underwent a simplified multidimensional geriatric assessment with a Charlson score administered by an oncologist, and the evaluation was submitted to a geriatrician who decided whether or not a complete a comprehensive geriatric assessment (CGA) (n=54) should be done. Another group of patients directly underwent a CGA (n=49), and a few patients included in a specific trial underwent a geriatric assessment (n=8). Each patient was classified as fit, vulnerable, or frail by a multidisciplinary team.


RESULTS
111 patients were included (median age: 81 years [range: 65-96]; 60 males). The most frequent types of cancer were lung (n=29), gastrointestinal (n=20) and head and neck (n=14). Median Charlson score was 2.1 [range: 0-9]. Standard therapy was given to 37/41 (90%) fit, 19/41 (42%) vulnerable, and 6/29 (21%) frail patients. Thirteen frail patients received best supportive care. A social worker was mobilized for 2/41 (5%) fit, 14/41 (34%) vulnerable, and 11/29 (38%) frail patients.


CONCLUSIONS
Our study outlines the possibilities of cooperation between geriatricians and oncologists in a general hospital. This collaboration could modify therapeutic schedules especially in frail and vulnerable patients.
Geriatric Department, CH de Draguignan, France. Electronic address: valentineb1@yahoo.fr.
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Bouzereau
Geriatric Department, CH de Draguignan, France. Electronic address: francoise.lecaer@ch-draguignan.fr.
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Le Caer
Oncology Department, CH de Draguignan, France. Electronic address: emmmanuel.guardiola@ch-draguignan.fr.
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Guardiola
Oncology Department, CH de Draguignan, France. Electronic address: catherine.scavennec@ch-draguignan.fr.
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Scavennec
Oncology Department, CH de Draguignan, France. Electronic address: jean.renaud.barriere@ch-draguignan.fr.
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Barriere
Geriatric Department, CH de Draguignan, France. Electronic address: Laurence.chaix@ch-draguignan.fr.
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Chaix
Oncology Department, CH de Draguignan, France. Electronic address: herve.lecaer@ch-draguignan.fr.
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Le Caer
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D005602:France; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009369:Neoplasms / Q000628:therapy*; D011795:Surveys and Questionnaires
Elderly patients; Geriatric assessment; Multidisciplinary assessment; Observational study; Oncology; Treatment schedules