title: Predictors of 1-Year Mortality in a Prospective Cohort of Elderly Patients With Cancer.
abstract: BACKGROUND
  Mortality prediction is crucial to select the optimal treatment in elderly cancer patients. Our objective was to identify cancer-related factors and Comprehensive Geriatric Assessment (CGA) findings associated with 1-year mortality in elderly inpatients and outpatients with cancer.
  
  
  METHODS
  We prospectively included patients aged ≥70 years who had solid or hematologic malignancies and in whom the CGA was performed by geriatricians in two French teaching hospitals. We identified independent predictors of 1-year mortality after study inclusion, using multivariate Cox models stratified on inpatient/outpatient status. We built three multivariate Cox models, since strong correlations linked activities of daily living (ADL), Eastern Cooperative Oncology Group Performance Status (ECOG-PS), and timed get-up-and-go test (GUG) results; and since physicians' preferences for these three assessments vary. A sensitivity analysis was performed using multiple imputation.
  
  
  RESULTS
  Of the 993 patients (mean age, 80.2 years; 51.2% men), 58.2% were outpatients and 46% had metastatic disease. Colorectal cancer was the most common malignancy (21.4%). Mortality rates after 6 and 12 months were 30.1% and 41.2%, respectively. In all models, tumor site and metastatic status (p < .001), age >80 years (p < .05), higher number of severe comorbidities (p < .05), and malnutrition (p < .001) were associated with death independently from impaired ECOG-PS (p < .001), ADL (p < .001), and GUG (p < .001). The adverse effect of metastatic status differed significantly across tumor sites, being greatest for breast and prostate cancer (p < .001). Multiple imputation produced similar results.
  
  
  CONCLUSIONS
  The predictors of 1-year mortality identified in our study may help physicians select the optimal cancer-treatment strategy in elderly patients.
authors.affiliation: Université Paris Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA 4393, UPEC, F-94010, Créteil, France. Primary Care Department, School of Medicine, Paris East Créteil University (UPEC), France. emilie.ferrat@u-pec.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Ferrat
authors.affiliation: Université Paris Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA 4393, UPEC, F-94010, Créteil, France. Geriatric Oncology Coordination Unit (UCOG).
authors.forename: Elena
authors.initials: E
authors.lastname: Paillaud
authors.affiliation: Université Paris Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA 4393, UPEC, F-94010, Créteil, France. Geriatric Oncology Coordination Unit (UCOG).
authors.forename: Marie
authors.initials: M
authors.lastname: Laurent
authors.affiliation: Université Paris Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA 4393, UPEC, F-94010, Créteil, France. Public Health Department, Clinical Research Unit (URC Mondor).
authors.forename: Aurélie
authors.initials: A
authors.lastname: Le Thuaut
authors.affiliation: Université Paris Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA 4393, UPEC, F-94010, Créteil, France. Geriatric Oncology Coordination Unit (UCOG).
authors.forename: Philippe
authors.initials: P
authors.lastname: Caillet
authors.affiliation: Medical Oncology Department, and.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tournigand
authors.affiliation: Radiotherapy Department, Henri-Mondor Teaching Hospital, APHP, Créteil, France.
authors.forename: Jean-Léon
authors.initials: JL
authors.lastname: Lagrange
authors.affiliation: Université Paris Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA 4393, UPEC, F-94010, Créteil, France. Public Health Department.
authors.forename: Florence
authors.initials: F
authors.lastname: Canouï-Poitrine
authors.affiliation: Université Paris Est, A-TVB DHU, CEpiA (Clinical Epidemiology and Ageing) Unit EA 4393, UPEC, F-94010, Créteil, France. Public Health Department, Clinical Research Unit (URC Mondor).
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bastuji-Garin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000401:mortality; D051346:Mobility Limitation; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000401:mortality*; D011446:Prospective Studies
keywords: Cancer; Elderly; Epidemiology.; Geriatric Assessment; Mortality