Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: An Italian group for geriatric oncology study
Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: An Italian group for geriatric oncology study
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DOI：
10.1200/jco.2002.20.2.494
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发表时间：
2002-01-15
影响因子：
45.3
通讯作者：
Zagonel, V
中科院分区：
文献类型：
--
作者：
Repetto, L;Fratino, L;Zagonel, V
目的：评价老年综合评估（CGA）在老年癌症患者中的应用价值（大于或等于65岁），并评估它是否可以增加更多关于东部肿瘤协作组体力状态（PS）的信息。（195例男性，168例女性;中位年龄72岁），患有实体（n = 271）或血液学（n = 92）肿瘤。除PS外，通过日常生活活动（ADL）和工具性日常生活活动（IADL）量表评估他们的身体功能。根据Satariano指数对合并症进行分类。结果：这363例老年癌症患者具有良好的功能和精神状态：74%的患者具有良好的PS（即低于2），86%的患者是ADL独立的，2%的患者是IADL独立的。41%的患者患有一种或多种共病。在PS良好的患者中，13.0%有两种或两种以上合并症; 9.3%和37.7%分别有ADL或IADL限制。通过多变量分析，ADL依赖或IADL依赖的老年癌症患者的Satariano指数升高的概率比独立患者高近两倍。PS和CGA之间出现了很强的关联，有一个穷人的PS（即，大于或等于2）记录在患者依赖ADL或IADL.Conclusion的概率增加了近5倍：CGA增加了大量的信息，老年癌症患者的功能评估，包括良好的PS患者。PS作为功能状态的独特标志物的作用需要在老年癌症患者中重新评估。(C)2002年，美国临床肿瘤学会。
Purpose : To appraise the performance of Comprehensive Geriatric Assessment (CGA) in elderly cancer patients (greater than or equal to 65 years) and to evaluate whether it could add further information with respect to the Eastern Cooperative Oncology Group performance status (PS).Patients and Methods: We studied 363 elderly cancer patients (195 males, 168 females; median age, 72 years) with solid (n = 271) or hematologic (n = 92) tumors. In addition to PS, their physical function was assessed by means of the activity of daily living (ADL) and instrumental activities of daily living (IADL) scales. Comorbidities were categorized according to Satariano's index. The association between PS, comorbidity, and the items of the CGA was assessed by means of logistic regression analysis.Results: These 363 elderly cancer patients had a good functional and mental status: 74% had a good PS (ie, lower than 2), 86% were ADL-independent, and 2% were IADL-independent. Forty-one percent of patients had one or more comorbid conditions. Of the patients with a good PS, 13.0% had two or more comorbidities; 9.3% and 37.7% had ADL or IADL limitations, respectively. By multivariate analysis, elderly cancer patients who were ADL-dependent or IADL-dependent had a nearly two-fold higher probability of having an elevated Satariano's index than independent patients. A strong association emerged between PS and CGA, with a nearly five-fold increased probability of having a poor PS (ie, greater than or equal to 2) recorded in patients dependent for ADL or IADL.Conclusion: The CGA adds substantial information on the functional assessment of elderly cancer patients, including patients with a good PS. The role of PS as unique marker of functional status needs to be reappraised among elderly cancer patients. (C) 2002 by American Society of Clinical Oncology.