Several Factors Predict Early Death in Elderly Patients Receiving Chemotherapy
(ChemotherapyAdvisor) – Advanced disease, a low Mini Nutritional Assessment (MNA) score, male sex, and poor mobility predicted early death in patients with cancer >70 years of age, investigators concluded in the Journal of Clinical Oncology online April 16.
Patients >70 years scheduled to receive first-line chemotherapy for colon, pancreas, stomach, ovary, bladder, prostate, lung, non-Hodgkin's lymphoma, or cancer of unknown primary origin (excluding breast cancer), were included in the study, which sought to identify objective factors that predict early death, defined as <6 months after initiation of chemotherapy.
Baseline abbreviated comprehensive geriatric assessment (aCGA), including the Mini-Mental State Exam, Timed Get Up and Go (GUG), Activities of Daily Living (ADL), Instrumental Activities in Daily Living (IADL), MNA, Geriatric Depression Scale (GDS15), and comorbidities index (Cumulative Index Rating Scale-Geriatric), was conducted. Prognostic factors of early death were sought from aCGA results and traditional oncology measures.
Median patient age was 77.45 years; the ratio of men to women was 1.47; and 65% of patients had advanced disease.
Of the 348 patients from 12 centers in Southwest France, abnormal aCGA scores were observed for 18.1% on the ADL, 73.0% on the IADL, 24.1% on the GUG, 19.0% on the MMS, 44.0% on the GDS15, and 64.9% on the MNA. Advanced disease (OR, 3.9), low MNA score (OR, 2.77), male sex (OR, 2.40), and long GUG (OR, 2.55) were associated with higher risk of early death.
“We recommend that the MNA and GUG, performed by a trained nurse, be maintained as part of routine pretreatment workup in these patients to identify at-risk patients and to inform the decision-making process for chemotherapy,” they concluded.