Association Between Geriatric Assessment and Post-Chemotherapy Functional Status in Older Patients with Cancer

Hánah N. Rier*, Marieke C. Meinardi, Joost van Rosmalen, Peter E. Westerweel, Eva de Jongh, Jos J.E.M. Kitzen, Joan van den Bosch, Marija Trajkovic, Mark David Levin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Maintaining functional status is among the most important patient-centered outcomes for older adults with cancer. This study investigated the association between comprehensive geriatric assessment (CGA) and progressive disease or decline of IADL-independence 1 year after chemotherapy, overall survival (OS), and premature termination of chemotherapy. CGA-based functional status and quality of life (QOL) 1 year after chemotherapy are also described. METHODS: This prospective cohort study involved patients aged ≥65 years treated with chemotherapy for any cancer type. CGA and the G8-screening tool were performed before and after the completion of chemotherapy. Analyses were adjusted for tumor type and treatment intent: (a) indolent hematological malignancies, (b) aggressive hematological malignancies, c) solid malignancies treated with curative intent, and (d) solid malignancies treated with palliative intent. RESULTS: All 291 included patients lived in The Netherlands; 193 (67.4%) lived fully independent prior to chemotherapy. The median age was 72 years; 164 (56.4%) were male. IADL independence, CGA-based functional status, and QOL were maintained in half of the patients 1 year after chemotherapy. An abnormal G8-score before chemotherapy was a higher risk for progressive disease or a decline of IADL-independence (OR 3.60, 95% CI, 1.98-6.54, P < .0001), prematurely terminated chemotherapy (OR 2.12, 95% CI, 1.24-3.65, P = .006), and shorter median OS (HR 1.71, 95% CI, 1.16-2.52, P = .007). The impact of an abnormal G8-score differed across tumor type (oncological or hematological) and treatment indication (adjuvant or palliative). CONCLUSION: An abnormal G8 score before chemotherapy is associated with progressive disease and functional decline after chemotherapy and shorter median OS, especially in patients with solid malignancies.

Original languageEnglish
Pages (from-to)e878-e888
JournalThe oncologist
Volume27
Issue number11
Early online date21 Jul 2022
DOIs
Publication statusPublished - Nov 2022

Bibliographical note

Funding:
This study was funded by ORAS (Oncological Research
Albert Schweitzer hospital). The foundation had no involvement in the conduct of the study.

Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press.

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