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1.
Schroder Sattar Shabbir M.H. Alibhai Sandra L. Spoelstra Martine T.E. Puts 《Journal of Geriatric Oncology》2019,10(1):98-104
Background
Falls are major health issues among older adults and even more so in those with cancer due to cancer and its treatment. Delays in cancer treatment caused by fall injuries may have significant implications on disease trajectory and patient outcomes. However, it is not known how falls impact cancer treatment in this population.Methods
We conducted a convergent-parallel mixed-methods study at the Princess Margaret Cancer Centre in Toronto, Canada, to examine how falls impact cancer treatment in community-dwelling cancer patients aged ≥?65, patients' fall reporting, and how falls were assessed and managed in oncology clinics. Data were collected by self-reported survey, chart review, and open-ended interviews.Results
One hundred older adults and fourteen oncologists participated. Falls were not commonly reported by patients to their oncologists (72 of 168 falls [43%] reported to researchers by patients were also reported to oncologists). One of fourteen oncologists routinely assessed falls. In 7% of all 72 reported falls, cancer treatment was impacted (e.g. treatment delay/cessation, dose reduction). Fifty-seven patients perceived their fall as minor incident not worth mentioning (amounted to a total of 72 falls not reported). When a participant reported their fall to the oncologist, actions were taken to assess and manage the fall. Oncologists indicated that the majority of patients were not forthcoming in reporting falls.Conclusion
One in twenty who fall appear to lead to change in cancer management. However, falls were not commonly reported by patients nor prioritized by oncologists. Incorporating routine fall assessment in oncology clinic appointments may help identify those at risk for falls so that timely interventions can be triggered. 相似文献2.
Min H. Huang Jennifer Blackwood Monica Godoshian Lucinda Pfalzer 《Journal of Geriatric Oncology》2019,10(1):89-97
Objectives
To identify predictors of falls in older breast and prostate cancer survivors.Methods
This retrospective cohort study analyzed population-based Surveillance, Epidemiology and End Results–Medicare Health Outcomes Survey (SEER-MHOS) linkage. Inclusion criteria were age >65?years at cancer diagnosis, first primary female breast or prostate cancer, cancer staging information available, completion of baseline MHOS during years 2–3 and follow-up MHOS during years 4–5 post-diagnosis, and falls information available. Data from 437 breast and 660 prostate cancer survivors were analyzed. Multivariable logistic regression was constructed to evaluate variables from baseline MHOS with relation to falls from follow-up MHOS. Model accuracy was assessed using area under receiver-operating-characteristic curve (AUC).Results
At follow-up MHOS, 26% of breast and 22% of prostate cancer survivors reported falls in the past 12?months. In breast cancer, a history of falls (odds ratio (OR)?=?4.95, 95% confidence interval (CI)?=?2.44–10.04) and sensory impairment in feet (OR?=?3.33, 95%CI?=?1.51–7.32) were significant predictors of falls. In prostate cancer, a history of falls (OR?=?3.04, 95%CI?=?1.79–5.15), unmarried (OR?=?1.82, 95%CI?=?1.12–2.95), lower physical summary score of quality-of-life(OR?=?0.96, 95%CI?=?0.94–0.98), urinary incontinence (OR?=?1.69, 95%CI?=?1.08–2.65), older age at diagnosis (OR?=?1.05, 95%CI?=?1.01–1.09), and shorter time post-diagnosis (OR?=?0.96, 95%CI?=?0.93–0.99) were significant predictors of falls. AUC was 0.67 and 0.77 for breast and prostate cancer, respectively, indicating moderate accuracy of models in detecting fallers.Conclusions
Asking older breast and prostate cancer survivors about falls in the past 12?months is imperative in fall prevention. Further examination of deficits specific to each cancer is necessary to assess fall risks. 相似文献3.
Sifra Bolle Ellen M.A. Smets Marije E. Hamaker Eugène F. Loos Julia C.M. van Weert 《Journal of Geriatric Oncology》2019,10(1):74-83
Objectives
Multidisciplinary team meetings aim to facilitate efficient and accurate communication surrounding the complex process of treatment decision making for older patients with cancer. This process is even more complicated for older (≥70?years) patients as the lack of empirical evidence on treatment regimens in patients with age-related problems such as comorbidity and polypharmacy, necessitates a patient-centred approach.This study investigates the decision making process for older patients with cancer during multidisciplinary team meetings and the extent to which geriatric evaluation and geriatric expertise contribute to this process.Methods
Non-participant observations of 171 cases (≥70?years) during 30 multidisciplinary team meetings in five hospitals and systematically analysed using a medical decision making framework. All cases were in patients with colon or rectal cancer.Results
First, not all steps from the medical decision making framework were followed. Second, we found limited use of patient-centred information such as (age-related) patient characteristics and patient preferences during the decision making process. Third, a geriatric perspective was largely missing in multidisciplinary team meetings.Conclusions
This study uncovers gaps in the treatment decision making process for older patients with cancer during multidisciplinary team meetings. In particular individual vulnerabilities and patient wishes are often neglected. 相似文献4.
5.
Leigha Rowbottom Allison Loucks Rana Jin Henriette Breunis Ali Taqi Syed Sarah Watt Narhari Timilshina Martine Puts Daniel Yokom Arielle Berger Shabbir M.H. Alibhai 《Journal of Geriatric Oncology》2019,10(2):229-234
Purpose
Geriatric assessment (GA) is recommended for older adults?≥?70?years with cancer to guide treatment selection. Screening tools such as the Vulnerable Elders Survey (VES-13) and G6 have been used to identify patients at highest need of GA. Whether either tool predicts a change in oncologic treatment following GA is unclear.Methods
Patients attending a geriatric oncology clinic between July 2015 and June 2017 who completed a VES-13 and underwent subsequent GA were included. Clinical information was extracted from a prospectively maintained database. G6 scores were assigned retrospectively. Patients were stratified into those who were “VES-13 positive” (score?≥?3) and “VES-13 negative” (score?<?3). Logistic regression was used to explore the relationship between VES-13 score, G6 score, and treatment modification.Results
Ninety-nine patients were seen prior to initiating cancer treatment. The median VES-13 score was 7; with 81.8% of patients scoring ≥3. The treatment plan was modified in 47.5% of patients after GA. VES-13 score was predictive of treatment plan modification (63.0% among VES-13 positive versus 16.7% among VES-13 negative patients; p?=?0.001). G6 performed similarly to the VES-13. The only statistically significant predictor of treatment change in multivariable analysis was performance status.Conclusion
VES-13 positive patients are more likely to undergo treatment modification to reduce treatment intensity or supportive care only. The VES-13 may provide oncologists with a rapid, reliable way of identifying vulnerability in older adults with cancer who may need further GA prior to commencing cancer treatment. 相似文献6.
7.
Keyvan Sasani Helen N. Catanese Alireza Ghods Seyed Ali Rokni Hassan Ghasemzadeh Robert J. Downey Armin Shahrokni 《Journal of Geriatric Oncology》2019,10(1):120-125
Purpose
Gait speed in older patients with cancer is associated with mortality risk. One approach to assess gait speed is with the ‘Timed Up and Go’ (TUG) test. We utilized machine learning algorithms to automatically predict the results of the TUG tests and its association with survival, using patient-generated responses.Methods
A decision tree classifier was trained based on functional status data, obtained from preoperative geriatric assessment, and TUG test performance of older patients with cancer. The functional status data were used as input features to the decision tree, and the actual TUG data was used as ground truth labels. The decision tree was constructed to assign each patient to one of three categories: “TUG?<?10?s”, “TUG?≥?10?s”, and “uncertain.”Results
In total, 1901 patients (49% women) with a mean age of 80?years were assessed. The most commonly performed operations were urologic, colorectal, and head and neck. The machine learning algorithm identified three features (cane/walker use, ability to walk outside, and ability to perform housework), in predicting TUG results with the decision tree classifier. The overall accuracy, specificity, and sensitivity of the prediction were 78%, 90%, and 66%, respectively. Furthermore, survival rates in each predicted TUG category differed by approximately 1% from the survival rates obtained by categorizing the patients based on their actual TUG results.Conclusions
Machine learning algorithms can accurately predict the gait speed of older patients with cancer, based on their response to questions addressing other aspects of functional status. 相似文献8.
Maarten van Heinsbergen Huub Maas Stan Bessems Jeroen Vogelaar Paul Nijhuis Liliane Keijzer-Bors Angela van Liempd Maryska Janssen-Heijnen 《Journal of Geriatric Oncology》2019,10(1):126-131
Introduction
One-year mortality after hospital discharge is higher among older patients with colorectal cancer who underwent surgery compared to younger patients. Taking care of older adults with multi-morbidity is often fragmented with lack of coordination and information exchange between healthcare professionals. The aim of this study was to evaluate emerging health problems and quality of life after implementing a standardized shared-care model.Material and Methods
141 patients aged ≥70?years who underwent surgery for colorectal carcinoma in two hospitals were included. A standardized transmission from hospital to primary care was set up. Patients' health status and quality of life was evaluated during subsequent follow-up moments.Results
A reduction in one-year mortality rate from 10.9% to 9.2% was observed after implementation of the standardized shared-care model. Almost all health status domains improved to ‘good’ during follow-up moments, still the general condition remained poor in 26% of patients at week fourteen. Although quality of life improved during subsequent follow-up moments, fatigue, dyspnoea and insomnia were the most prominent persisting problems at the end of follow-up.Discussion
The implementation of a standardized shared-care model for older patients after surgery for colorectal cancer resulted in a reduction in the one year mortality rate. Although most aspects of both health status and quality of life improved during subsequent follow-up moments, especially the general condition remained poor for a long time after surgery. This means that, besides a good preoperative counseling of patients, future research should focus on possible interventions to improve general condition. 相似文献9.
Joyita Banerjee Sujata Satapathy Ashish Dutt Upadhyay Sada Nand Dwivedi Prasun Chatterjee Lalit Kumar Goura Kishor Rath Aparajit Ballav Dey 《Journal of Geriatric Oncology》2019,10(2):222-228
Introduction
With rise in incidence and prevalence of cancers in the ageing population, the need for an age sensitive comprehensive assessment measure has been felt. Comprehensive Geriatric Assessment (CGA) is often difficult to implement due to time and logistic constraints. A brief assessment tool encompassing the specific domains of the CGA would be a better way to assess older adults with cancer. These tools exist but have not necessarily been culturally adapted. The main aim of the study was to develop a culturally relevant short geriatric assessment tool and explore its psychometric properties.Methodology
An initial item pool was formed after review of the literature and study of the existing scales. This draft tool was then pre and pilot tested to finalize the items and check the feasibility of application. The final tool was validated by exploratory factor analysis on a sample of 100 older patients with cancer.Results
After pre and pilot study on fifteen and thirty older patients with cancer respectively, this tool consisting of a total of 38 items spread over eight domains was developed and validated on a sample of 100 subjects. Due to co-linearity, three items were deleted after exploratory factor analysis, bringing the final item number to35. The Cronbach's alpha was 0.93 and the intra-class correlation co-efficient (ICC) was 0.94. Thus, the final tool had 13 questions with sub-parts (35 items in total). The time taken to administer the tool was around 25?min.Conclusion
The tool developed is valid and reliable and can be used for the initial assessment and further care planning of older Indian patients with cancer. 相似文献10.
Timothy H.M. To Wee Kheng Soo Heather Lane Adnan Khattak Christopher Steer Bianca Devitt Haryana M. Dhillon Anne Booms Jane Phillips 《Journal of Geriatric Oncology》2019,10(2):216-221
Introduction
Geriatric assessment (GA) is a multidimensional health assessment of the older person to evaluate their physical and cognitive function, comorbidities, nutrition, medications, psychological state, and social supports. GA may help oncologists optimise care for older patients with cancer. The aim of this study was to explore the views of Australian medical oncologists regarding the incorporation of geriatric screening tools, GA and collaboration with geriatricians into routine clinical practice.Methods
Members of the Medical Oncology Group of Australia were invited to complete an online survey that evaluated respondent demographics, practice characteristics, treatment decision-making factors, use of GA, and access to geriatricians.Results
Sixty-nine respondents identified comorbidities, polypharmacy, and poor functional status as the most frequent challenges in caring for older patients with cancer. Physical function, social supports and nutrition were the most frequent factors influencing treatment decision-making. The majority of respondents perceived value in GA and geriatrician review, although access was a barrier for referral. Such services would need to be responsive, providing reports within two weeks for the majority of respondents.Conclusion
Despite an emerging evidence base for the potential benefits of GA and collaboration with geriatricians, medical oncologists reported a lack of access but a desire to engage with these services. 相似文献11.
12.
Mackenzi Pergolotti Michelle M. Langer Allison M. Deal Hyman B. Muss Kirsten Nyrop Grant Williams 《Journal of Geriatric Oncology》2019,10(2):241-245
Objectives
The Mental Health Index (MHI) is widely used as a measure of mental health status, but has not been evaluated in the geriatric oncology population. This study evaluated the MHI-17 in a geriatric oncology population, to establish validity and scoring rules.Materials and Methods
The Carolina Senior Registry (NCT01137825) was used to obtain data for 686 patients with cancer 65 and older who completed the MHI-17. The 17-item patient-reported measure produces one total score summing across four domains: anxiety, depression, positive affect, and sense of belonging. Cronbach's alpha (α), confirmatory factor analyses (CFA), item-response theory (IRT) analyses, and differential item functioning (DIF) analyses were used to evaluate internal consistency and validity.Results and Discussion
The revised MHI retained the 13 best-fitting items from the MHI-17 and resulted in a final model that included two subscales: anxiety (four items, RMSEA 0.11; CFI 0.99; TLI 0.98) and depression (9 items, RMSEA 0.10; CFI 0.96; TL 0.95). IRT analyses of the four anxiety items indicated good fit (RMSEA 0.08) and precise measurement of adults with poor mental health, and the nine depression items also fit well (RMSEA 0.05). No meaningful differences were found by sex, education, or treatment stage. Scores were developed to provide meaningful norms. The new MHI-13 is a shorter, more accurate way to assess mental health in older adults with cancer and most importantly allows clinicians to separately identify anxiety and/or depression - a clinically important distinction as treatment differs among these two types of mental health impairment. 相似文献13.
Audrey Rambeau Bérengère Beauplet Heidi Laviec Idlir Licaj Alexandra Leconte Claire Chatel Priscille Le Bon Julie Denhaerynck Bénédicte Clarisse Nicole Frenkiel Marie Lange Florence Joly 《Journal of Geriatric Oncology》2019,10(2):235-240
Introduction
Among the various instruments recommended by the International Society of Geriatric Oncology, the Mini Mental State Examination (MMSE) is the most commonly used cognitive screening test before oncological treatment. Although the Montreal Cognitive Assessment (MoCA) has been shown to be more sensitive than the MMSE in several pathologies, no specific data exist for older patients with cancer. We aimed to compare the proportions of older patients with cancer who had screened positive for cognitive impairment according to the MMSE and MoCA scores obtained during a pretherapeutic geriatric assessment (GA) in oncology.Patients and methods
This prospective study was conducted among 66 patients older than 70?years who were candidates for a first-line treatment for either a solid tumor or hematological malignancy. Patients with brain tumor or previously known dementia were ineligible. During GA, cognitive function was assessed using both the MoCA and the MMSE tests administered in a random order.Results
Median age was 78?years. Most patients (n?=?43, 65.2%) had a solid tumor. The median scores were 26 [11–30] for MMSE and 24 [8–30] for MoCA. Thirteen (19.7%) and 44 (66.7%) patients were screened positive for cognitive impairment according to MMSE and MoCA scores, respectively. Overall, 55 (66.7%) patients were screened positive: 12 (21.8%) on both scores, 32 (70.5%) with the MoCA only, and one patient with MMSE only (p?<?0.0001).Conclusion
The MoCA test seems to be most relevant to screen for cognitive impairment in older patients with cancer. 相似文献14.
Tyler Raycraft Winson Y. Cheung Yaling Yin Caroline Speers Jenny J. Ko Caroline Mariano 《Journal of Geriatric Oncology》2019,10(1):138-142
Objectives
Life expectancy plays a key role in the selection of patients with stage III colon cancer for adjuvant chemotherapy, but little is known about causes of mortality in older patients with colon cancer. We aimed to examine causes of death in this population and compare these causes between patients who received chemotherapy and those who did not. Specifically, we chose to examine the rates of death related to recurrent colon cancer versus non colon cancer.Materials and Methods
Patients aged 50 and older diagnosed with stage III colon cancer between 2005 and 2009 were included. Patients were divided into “younger” (aged 50–69) and “older” (aged 70+). Causes of death, which were categorized into colon cancer versus non-colon cancer related.Results
1361 patients were included, 50% of whom were 70 or older. Younger patients were more likely to receive adjuvant chemotherapy (90% vs. 60%). 601 patients died in the follow up period. Deceased patients in the younger group were more likely to die from colon cancer (81% vs. 62%). The most common cause of non-colon cancer death was other primary malignancies in younger patients and cardiovascular diseases in older patients. In older patients who received chemotherapy, 41% died; 89% of these deaths were related to colon cancer. In older patients who did not receive chemotherapy 72% died, with 38% of patients ultimately dying from colon cancer.Conclusions
Older patients remain under-treated with chemotherapy. Although non-colon cancer deaths were more frequent in older patients with cancer, colon cancer was a still a significant cause of mortality. These deaths may be preventable with adjuvant chemotherapy. 相似文献15.
Doris L. van Abbema Marjan van den Akker Maryska L. Janssen-Heijnen Franchette van den Berkmortel Ann Hoeben Judith de Vos-Geelen Frank Buntinx Jos Kleijnen Vivianne C.G. Tjan-Heijnen 《Journal of Geriatric Oncology》2019,10(1):31-41
Objective
The aim of this systematic review was to investigate patient-related factors (e.g. depressive symptoms, cognition, mobility, activities of daily living (ADL)) as well as tumor-related factors (e.g. tumor type, chemotherapy regimen) influencing chemotherapy intolerance in cancer patients aged 65?years or older.Methods
We included observational studies that reported data on possible predictors of chemotherapy intolerance in older patients with cancer. We studied chemotherapy intolerance using the following outcomes: chemotherapy toxicity grade 3 to 5, unplanned hospitalization, chemotherapy discontinuation, chemotherapy dose reduction, functional decline, and chemotherapy mortality. We searched PubMed, Embase, and PsycInfo for articles between January 1995 and July 2016. The quality of the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool.Results
The search yielded 1774 articles, and 30 articles from 27 studies were included. The patient-related factors associated with chemotherapy intolerance, in terms of the size of the association and the consistency of the results, were more than one fall in the last six months, mobility problems, poor performance status and the presence of severe comorbid conditions. The tumor-related factors that were associated with chemotherapy intolerance in older patients with cancer were certain regimens of chemotherapy and polychemotherapy, as compared to monochemotherapy. The number of studies on unplanned hospitalization and functional decline was small.Conclusion
The included studies were heterogeneous with respect to endpoints and included parameters. Nevertheless, the size of the association and the consistency of results suggest that all these factors are relevant for everyday oncological practice. 相似文献16.
Jan J. Jobsen Judith G. Middelburg Job van der Palen Sietske Riemersma Ester Siemerink Henk Struikmans Sabine Siesling 《Journal of Geriatric Oncology》2019,10(2):330-336
Background
The aim of this study was to analyze the distant metastases-free survival (DMFS), and disease-specific survival (DSS) after breast-conserving therapy (BCT) in older patients with breast cancer in a large, population-based, single-center cohort study with long-term follow-up.Material and Methods
Analyses were based on 1,425 women aged 65?years and older with breast cancer treated with BCT. Patients were divided in three age categories: 65 – 70?years, 71 – 75?years, and >75?years. The study period extended over 30 years, divided in three decades. Multivariate survival analysis was carried out using Cox regression analysis.Results
The two youngest age categories showed significant improvements over time in 12-year DMFS and DSS. For women aged 65 – 70?years, this improvement was noted in stage I and stage II disease, while for women aged 71 – 75?years this was mainly in stage II tumors. Women >75 years of age did not show any improvement over time, regardless of stage.Conclusion
Among older Dutch women with breast cancer, outcomes with regard to DMFS and DSS after BCT differ between various age categories, showing the least gain in the very old. 相似文献17.
Francisco J. Tarazona-Santabalbina Jorge Llabata-Broseta Ángel Belenguer-Varea David Álvarez-Martínez David Cuesta-Peredo Juan A. Avellana-Zaragoza 《Journal of Geriatric Oncology》2019,10(2):298-303
Objectives
Comprehensive geriatric assessment (CGA) has shown to benefit older patients undergoing urological and orthopedic surgery. However, this approach has been scarcely assessed in patients elected for colorectal surgery.Materials and Methods
Retrospective cohort of patients aged ≥70?years admitted for elective colorectal cancer surgery to a single hospital between 2008 and 2012. Upon admission, patients were assigned to a usual care (UC) plan or a CGA-based care (GS) plan conducted by a multidisciplinary team, according to standard clinical criteria.Analyzed outcomes included the incidence of delirium and other geriatric syndromes during hospital stay, mortality, readmissions, andnumber of perioperative complications.Results
The cohort included 310 patients, 203 assigned to the GS group and 107 to the UC group. Patients in the GS group had significantly lower Barthel and Lawton scores, higher prevalence of dementia and heart failure, and higher comorbidity burden. Fifty-four (17.5%) patientsexperienced delirium (23 [11.3%] and 31 [29.2%] in the GS and UC groups, respectively; p?<?.001), and 49 (15.8%) patient experienced other geriatric syndromes (21 [10.3%] and 28 [26.2%] in the GS and UC groups, respectively; p?<?.001). Serious complications were more frequent in the GS group: 154 (75.9%) vs 60 (56.1%) in the UC group; p?<?.001. No significant differences were observed between groups regarding readmissions, and in-hospital and post-discharge (1?year follow-up) mortality.Conclusions
Despite the poorer clinical condition of patients in the GS group, the CGA-based intervention resulted in a lower incidence of delirium and other geriatric syndromes compared with the UC group. 相似文献18.
Scott Kizy Ariella M. Altman Schelomo Marmor Jason W. Denbo Eric H. Jensen Todd M. Tuttle Jane Yuet Ching Hui 《Journal of Geriatric Oncology》2019,10(2):322-329
Introduction
The 21-gene recurrence score (RS) (Oncotype Dx, Genomic Health, Redwood City Ca) has not been validated in an older cohort with estrogen receptor (ER)-positive breast cancer. The objective of this study was to evaluate RS validity in a group of older women with ER-positive breast cancer.Methods
Utilizing the Surveillance, Epidemiology, and End Results Program (SEER) database with available RS, we evaluated women with ER-positive breast cancer aged 18–69 and those 70?years of age and older from 2004 to 2014. We utilized multivariable logistic regression models to evaluate factors associated with RS testing as well as a high-risk categorization for those who underwent testing. Survival was analyzed using Kaplan Meier curves and Cox proportional hazard models.Results
We identified 363,876 women aged 18–69?years and 147,107 women aged 70?years and older. A smaller proportion of patients in the older group (8%) underwent RS testing than in the younger group (18%). Of the patients who underwent testing, distribution of RS was similar between groups. High-risk categorization independently predicted a higher likelihood of death for older patients (hazard ratio 1.47, 95% confidence interval 1.15–1.90). Among patients with high-risk RS, chemotherapy was associated with a decreased risk of death in the younger group, but not in the older group.Conclusion
Older women are less likely to receive RS testing, but when tested, older patients have a similar distribution of RS as compared to younger patients. While high-risk categorization in the older cohort was prognostic, chemotherapy was not associated with improved survival. 相似文献19.
Tomohiro F. Nishijima Allison M. Deal Jennifer L. Lund Kirsten A. Nyrop Hyman B. Muss Hanna K. Sanoff 《Journal of Geriatric Oncology》2019,10(2):279-284
Background
Our aim was to evaluate the prognostic impact of three inflammatory markers - neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and lymphocyte monocyte ratio (LMR) - on overall survival (OS) in older adults with cancer.Materials and Methods
Our sample includes 144 patients age?≥?65?years with solid tumor cancer who completed a cancer-specific Geriatric Assessment (GA) from 2010 to 2014 and had pretreatment CBC with differential. NLR was dichotomized a previously reported cut-off value of 3.5, while PLR and LMR were dichotomized at the median. Cox proportional hazards models evaluated whether NLR, PLR and LMR were predictive of OS independent of covariates including a recently developed 3-item GA-derived prognostic scale consisting of (1) “limitation in walking several blocks”, (2) “limitation in shopping”, and (3) “≥ 5% unintentional weight loss in 6 months”.Results
Median age was 72?years, 53% had breast cancer, 27% had stage 4 cancer, 14% had Karnofsky Performance Status (KPS)?<?80, 11% received less intensive than standard treatment for stage, and 39% had NLR?>?3.5. In univariable analysis, higher NLR and PLR and lower LMR were significantly associated with worse OS. NLR remained a significant predictor of OS (HR?=?2.16, 95% CI; 1.10–4.25, p?=?.025) after adjusting for cancer type, stage, age, KPS, treatment intensity, and the GA-derived prognostic scale.Conclusion
NLR?>?3.5 is predictive of poorer OS in older adults with cancer, independent of traditional prognostic factors and the GA-derived prognostic scale. 相似文献20.
Marije E. Hamaker Marthe te Molder Noortje Thielen Barbara C. van Munster Anandi H. Schiphorst Lieke H. van Huis 《Journal of Geriatric Oncology》2018,9(5):430-440