title: Relevance of Geriatric Assessment in Older Patients With Colorectal Cancer.
abstract: This study aims to evaluate the relevance of geriatric assessment (GA) in older patients with colorectal cancer (CRC) and to study functional status (FS) and chemotherapy-related toxicity during treatment.
  
  
  
  Patients with CRC aged ≥ 70 years were evaluated at baseline using a GA. Results were communicated to the treating physician. At 2 to 3 months follow-up, FS was reassessed, and chemotherapy-related toxicity was recorded.
  
  
  
  A total of 193 patients, with a median age of 77 years, were included. GA was abnormal in 75% and revealed unknown problems in 40%. Treatment was altered in 37% based on clinical assessment. GA led to geriatric interventions in 9 patients (5%) and additionally influenced treatment in 1 patient. At follow-up (n = 164), functional decline was observed in 29 patients (18%) for activities of daily living (ADL) and in 60 patients (37%) for instrumental activities of daily living (IADL). Baseline IADL, depression, fatigue, and cognition were predictors for ADL decline, whereas no predictors for IADL decline could be identified. In the 109 patients receiving chemotherapy, stage and baseline fatigue were predictive for grade 3/4 hematologic toxicity, and baseline ADL, fatigue, and nutrition were predictive for grade 3/4 nonhematologic toxicity.
  
  
  
  Although GA identified previously unknown problems in more than one-third of older CRC patients, the impact on interventions or treatment decisions was limited. Baseline GA parameters may predict functional decline and chemotherapy-related toxicity. Education of physicians treating older patients with CRC is an essential step in the implementation of GA and subsequent interventions.
authors.affiliation: Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium. Electronic address: lore.decoster@uzbrussel.be.
authors.forename: Lore
authors.initials: L
authors.lastname: Decoster
authors.affiliation: Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Vanacker
authors.affiliation: Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Cindy
authors.initials: C
authors.lastname: Kenis
authors.affiliation: Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Prenen
authors.affiliation: Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Erik
authors.initials: E
authors.lastname: Van Cutsem
authors.affiliation: Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium; Department of Gastroenterology, AZ St Monica, Deurne, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Van Der Auwera
authors.affiliation: Department of Surgery, UZ Brussel, Brussels, Belgium.
authors.forename: Ellen
authors.initials: E
authors.lastname: Van Eetvelde
authors.affiliation: Department of Geriatric Medicine, ASZ, Aalst, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Van Puyvelde
authors.affiliation: Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Flamaing
authors.affiliation: Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Milisen
authors.affiliation: Consultant in Statistics, Beernem, Belgium.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Lobelle
authors.affiliation: Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: De Grève
authors.affiliation: Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Wildiers
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000628:therapy; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies
keywords: Biologic age; Chemotherapy-related toxicity; Elderly; Functional decline; Treatment decision