論文

査読有り 国際誌
2020年8月

Geriatric assessment domains to predict overall survival in older cancer patients: An analysis of functional status, comorbidities, and nutritional status as prognostic factors.

Cancer medicine
  • Toshitaka Morishima
  • ,
  • Akira Sato
  • ,
  • Kayo Nakata
  • ,
  • Isao Miyashiro

9
16
開始ページ
5839
終了ページ
5850
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/cam4.3205
出版者・発行元
Wiley

Cancer treatments for older patients must account for heterogeneity in health and functional status. Guidelines advocate the use of geriatric assessments (GAs), but comprehensive assessments are laborious and the utility of specific GA domains remains unclear. The identification of specific domains as prognostic factors may support survival predictions and treatment decisions. We aimed to evaluate the associations between several GA domains and overall survival in older cancer patients. We linked cancer registry data and administrative claims data from cancer patients residing in Osaka Prefecture, Japan. The subjects were patients aged ≥70 years who received a diagnosis of gastric, colorectal, or lung cancer between 2010 and 2014 at 36 designated cancer care hospitals. The following three GA domains were assessed at cancer diagnosis: functional status through activities of daily living (ADL), comorbidities, and nutritional status through body mass index. Cox proportional hazards models were constructed for the three cancer types to estimate each domain's prognostic effect while adjusting for gender, age, and cancer stage. Adjusted hazard ratios (HRs) for all-cause mortality were calculated. We identified 5,559, 4,746, and 4,837 patients with gastric, colorectal, and lung cancer respectively. ADL impairment (HRs: 1.39-3.34, 1.64-2.86, and 1.24-3.21 for gastric, colorectal, and lung cancer, respectively), comorbidities (1.32-1.58, 1.33-1.97, and 1.19-1.29 for gastric, colorectal, and lung cancer, respectively), and underweight (1.36, 1.51, and 1.54 for gastric, colorectal, and lung cancer, respectively) were significantly associated with poorer overall survival. In contrast, overweight was significantly associated with improved overall survival (HRs: 0.82 and 0.89 for gastric and lung cancer respectively). The addition of the three domains increased the models' C-statistics (0.816 to 0.836, 0.764 to 0.787, and 0.759 to 0.783 for gastric, colorectal, and lung cancer respectively). Incorporating these factors into initial patient evaluations during diagnosis may aid prognostic predictions and treatment strategies in geriatric oncology.

リンク情報
DOI
https://doi.org/10.1002/cam4.3205
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32618120
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433808
URL
https://onlinelibrary.wiley.com/doi/am-pdf/10.1002%2Fcam4.3205
URL
http://onlinelibrary.wiley.com/wol1/doi/10.1002/cam4.3205/fullpdf
ID情報
  • DOI : 10.1002/cam4.3205
  • ISSN : 2045-7634
  • PubMed ID : 32618120
  • PubMed Central 記事ID : PMC7433808

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