title: Follow-up of elderly patients with urogenital cancers: Evaluation of geriatric care needs and related actions.
abstract: OBJECTIVE
  To investigate a comprehensive geriatric assessment (CGA) with subsequent investigation of healthcare patterns in older patients with urological cancers undergoing initial surgery or radiotherapy, to verify the usefulness of the incorporation of geriatric principles in future care plans.
  
  
  METHODS
  This is a prospective cohort study. From November 2011 to March 2015, CGA was offered to all patients aged 70+ years treated with radiotherapy or surgery at seven tertiary centers. Patients were classified as fit, vulnerable, or frail according to Balducci's definition. CGA and follow-up data were collected by two trained evaluators at 6 and 12months. The information collected was not available to the caring physicians during follow-up.
  
  
  RESULTS
  CGA was performed in 453 patients with prostate cancer (295), bladder cancer (126), or kidney cancer (32). 40% of patients with prostate cancer were fit, 47% vulnerable, and 13% frail. The corresponding values for renal cancer were 25%, 40%, and 34%, and for bladder cancer, 21%, 42%, and 37%. During follow-up, 60% of patients with cardiac diseases, 42% of those with diabetes/other metabolic disorders, 35% of those with hypertension, and 35% of those with respiratory diseases were followed by a specialist (for these severe/extremely severe comorbidities). Of 16 patients with ADL impairment and 63 with IADL impairment, only 4 (25%) and 6 (10%), respectively, were referred to a rehabilitation service. Only one case was referred to a geriatrician.
  
  
  CONCLUSIONS
  Appropriate clinical care patterns are advisable to improve quality of survivorship in older patients with urological cancers.
authors.affiliation: Istituto Palazzolo Fondazione Don Gnocchi, Milano, Italy. Electronic address: smonfardini@dongnocchi.it.
authors.forename: Silvio
authors.initials: S
authors.lastname: Monfardini
authors.affiliation: Radioterapia, Istituto Nazionale Tumori Milano, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Morlino
authors.affiliation: Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Valdagni
authors.affiliation: Chirurgia Urologica Istituto Nazionale Tumori Milano, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Catanzaro
authors.affiliation: Clinica Urologica Università degli Studi Milano, Italy.
authors.forename: Ardit
authors.initials: A
authors.lastname: Tafa
authors.affiliation: Radioterapia Ospedale Niguarda, Milano, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bortolato
authors.affiliation: Urologia Ospedale Niguarda, Milano, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Petralia
authors.affiliation: Radioterapia Ospedale S. Gerardo, Monza, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bonetto
authors.affiliation: Radioterapia Istituto Clinico Humanitas, Rozzano, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Villa
authors.affiliation: Urologia Ospedale Policlinico San Donato, San Donato Milanese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Picozzi
authors.affiliation: Oncologia Medica, Ospedale San Carlo, Milano, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Locatelli
authors.affiliation: Istituto Palazzolo Fondazione Don Gnocchi, Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Galetti
authors.affiliation: IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Millul
authors.affiliation: IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Albanese
authors.affiliation: IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bianchi
authors.affiliation: Istituto Palazzolo Fondazione Don Gnocchi, Milano, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Panzarino
authors.affiliation: Istituto Palazzolo Fondazione Don Gnocchi, Milano, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gerardi
authors.affiliation: IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005500:Follow-Up Studies; D000073496:Frailty / Q000175:diagnosis; D015577:Geriatric Assessment; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D008297:Male; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D012720:Severity of Illness Index; D000073859:Survivorship; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy
keywords: Bladder cancer; Elderly; Geriatric assessment; Prostate cancer; Renal cancer; Urogenital cancer