Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study.
Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study.
复制标题
筛查老年癌症患者的脆弱性：Oncodage前瞻性多中心队列研究。
DOI：
10.1371/journal.pone.0115060
复制
发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Rainfray M
中科院分区：
文献类型：
--
作者：
Soubeyran P;Bellera C;Goyard J;Heitz D;Curé H;Rousselot H;Albrand G;Servent V;Jean OS;van Praagh I;Kurtz JE;Périn S;Verhaeghe JL;Terret C;Desauw C;Girre V;Mertens C;Mathoulin-Pélissier S;Rainfray M
老年评估是一种适当的方法来识别老年癌症患者在治疗过程中有危及生命的事件的风险。然而，它在实践中没有得到充分利用，主要是因为它耗时耗力。本研究旨在通过比较G8和脆弱老年人调查（vs -13）两种短期评估工具的表现，确定识别需要老年评估的老年癌症患者的最佳筛查工具。在一项对23家卫生保健机构治疗前积累的1674名癌症患者进行的前瞻性队列研究中，评估了G8和（vs -13）的诊断准确性。1435例符合条件并可评估。结果指标为多维老年评估（MGA）、敏感性（主要）、特异性、G8和VES-13阴性预测值和阳性似然比、1年生存率预测因素。患者年龄中位数为78.2岁（70-98岁），以女性居多（69.8%），不同类型的肿瘤，其中乳腺癌占53.9%，表现状态0-1的占75.8%。MGA、G8和VES-13分别为80.2%、68.4%和60.2%。完成G8或VES-13的平均时间约为5分钟。两份问卷的重现性较好。G8更敏感（76.5%比68.7%,P = 0.0046），而vs -13更特异性（74.3%比64.4%，P<0.0001）。G8评分异常（HR = 2.72）、病情进展（HR = 3.30）、男性（HR = 2.69）、运动状态差（HR = 3.28）是影响患者1年生存的独立预后因素。G8问卷具有良好的敏感性和独立的1年生存率预后价值，是目前识别需要老年评估的老年癌症患者的最佳筛查工具之一，我们认为应在日常实践中广泛实施。在可能危及生命的治疗之前，应该继续进行研究工作，以完善老年癌症患者的选择过程。
Geriatric Assessment is an appropriate method for identifying older cancer patients at risk of life-threatening events during therapy. Yet, it is underused in practice, mainly because it is time- and resource-consuming. This study aims to identify the best screening tool to identify older cancer patients requiring geriatric assessment by comparing the performance of two short assessment tools the G8 and the Vulnerable Elders Survey (VES-13). The diagnostic accuracy of the G8 and the (VES-13) were evaluated in a prospective cohort study of 1674 cancer patients accrued before treatment in 23 health care facilities. 1435 were eligible and evaluable. Outcome measures were multidimensional geriatric assessment (MGA), sensitivity (primary), specificity, negative and positive predictive values and likelihood ratios of the G8 and VES-13, and predictive factors of 1-year survival rate. Patient median age was 78.2 years (70-98) with a majority of females (69.8%), various types of cancer including 53.9% breast, and 75.8% Performance Status 0-1. Impaired MGA, G8, and VES-13 were 80.2%, 68.4%, and 60.2%, respectively. Mean time to complete G8 or VES-13 was about five minutes. Reproducibility of the two questionnaires was good. G8 appeared more sensitive (76.5% versus 68.7%, P = 0.0046) whereas VES-13 was more specific (74.3% versus 64.4%, P<0.0001). Abnormal G8 score (HR = 2.72), advanced stage (HR = 3.30), male sex (HR = 2.69) and poor Performance Status (HR = 3.28) were independent prognostic factors of 1-year survival. With good sensitivity and independent prognostic value on 1-year survival, the G8 questionnaire is currently one of the best screening tools available to identify older cancer patients requiring geriatric assessment, and we believe it should be implemented broadly in daily practice. Continuous research efforts should be pursued to refine the selection process of older cancer patients before potentially life-threatening therapy.
登录
查看更多内容
影响因子：
45.3
作者：
Hoppe, Stephanie;Rainfray, Muriel;Soubeyran, Pierre
通讯作者：
Soubeyran, Pierre
影响因子：
3
作者：
Luce, S.;De Breucker, S.;Pepersack, T.
通讯作者：
Pepersack, T.
影响因子：
6.2
作者：
Extermann, Martine;Boler, Ivette;Balducci, Lodovico
通讯作者：
Balducci, Lodovico
影响因子：
39.2
作者：
Bossuyt, PM;Reitsma, JB;de Vet, HCW
通讯作者：
de Vet, HCW
影响因子：
39.2
作者：
Cigolle, Christine T.;Langa, Kenneth M.;Blaum, Caroline S.
通讯作者：
Blaum, Caroline S.