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Billon E, Tassy L, Boulogne O, Cecile M, Braticevic C, Pibarot M, Rousseau F. [Very old patients in multidisciplinary team meeting in PACA: a one-year survey]. Bull Cancer 2021; 108:1036-1043. [PMID: 34561024 DOI: 10.1016/j.bulcan.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/02/2021] [Accepted: 05/21/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In 2011, 11% of all cancers were diagnosed in people over 85 years old. With the current aging of the French population associated with health progress, we will be confronted more and more frequently with the treatment of very old patients, and this until the horizon 2050, when the population over 75 years old will represent approximately 15% of the total French population (compared to 9.1% in 2015). METHODS To understand the management methods for patients over 85 years old with cancer, we carried out an observational study, based on data collected in the OncoPACA-Corse network, with the objective to describe the demographic data of very elderly patients, the characteristics of their pathology and to analyze the therapeutic strategies proposed by oncologists to patients in this population. RESULTS One thousand three hundred and fifty five cases were analyzed. The mean age of the patients was 88.9 years with 3% of patients over 95 years old and only one was over 100 years old. 51.6% were women. Digestive tumors were the most represented (23.4%), followed by breast tumors (17.7%) and prostate tumors (10.5%), with a diagnosis made at a metastatic stage in 20% of cases. We note that treatment was offered for nearly 85% of patients with a wide range of options, exclusive palliative care was offered in 15% of cases; and whena treatment considered to be not very aggressive, such as hormone therapy, was offered, it seems to be preferred as monotherapy.
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Affiliation(s)
- Emilien Billon
- Institut Paoli-Calmettes, oncologie médicale, 13000 Marseille, France.
| | - Louis Tassy
- Institut Paoli-Calmettes, oncologie médicale, 13000 Marseille, France
| | | | - Maud Cecile
- Institut Paoli-Calmettes, oncologie médicale, 13000 Marseille, France
| | - Cécile Braticevic
- Institut Paoli-Calmettes, oncologie médicale, 13000 Marseille, France
| | - Michèle Pibarot
- Réseau régional de cancérologie OncoPaca-Corse, Marseille, France
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Fariña‐Castro R, Roque‐Castellano C, Artiles‐Armas M, Marchena‐Gómez J. Emergency surgery and American Society of Anesthesiologists physical status score are the most influential risk factors of death in nonagenarian surgical patients. Geriatr Gerontol Int 2019; 19:293-298. [DOI: 10.1111/ggi.13624] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/03/2018] [Accepted: 12/27/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Roberto Fariña‐Castro
- Department of AnesthesiologyUniversity Hospital of Gran Canaria Dr. Negrín Las Palmas de Gran Canaria Spain
- Department of Medical and Surgical Science, University of Las Palmas de Gran Canaria Las Palmas de Gran Canaria Spain
| | - Cristina Roque‐Castellano
- Department of General and Digestive SurgeryUniversity Hospital of Gran Canaria Dr. Negrín Las Palmas de Gran Canaria Spain
- Department of Medical and Surgical Science, University of Las Palmas de Gran Canaria Las Palmas de Gran Canaria Spain
| | - Manuel Artiles‐Armas
- Department of General and Digestive SurgeryUniversity Hospital of Gran Canaria Dr. Negrín Las Palmas de Gran Canaria Spain
- Department of Medical and Surgical Science, University of Las Palmas de Gran Canaria Las Palmas de Gran Canaria Spain
| | - Joaquín Marchena‐Gómez
- Department of General and Digestive SurgeryUniversity Hospital of Gran Canaria Dr. Negrín Las Palmas de Gran Canaria Spain
- Department of Medical and Surgical Science, University of Las Palmas de Gran Canaria Las Palmas de Gran Canaria Spain
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Au S, Ventham NT, Yalamarthi S, Manimaran N. Colorectal cancer outcomes in nonagenarian patients: A case series. Int J Surg 2018; 55:139-144. [DOI: 10.1016/j.ijsu.2018.05.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/07/2018] [Accepted: 05/19/2018] [Indexed: 12/12/2022]
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Arnold BN, Thomas DC, Rosen JE, Salazar MC, Detterbeck FC, Blasberg JD, Boffa DJ, Kim AW. Effectiveness of local therapy for stage I non-small-cell lung cancer in nonagenarians. Surgery 2017; 162:640-651. [PMID: 28697883 DOI: 10.1016/j.surg.2017.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/16/2017] [Accepted: 04/11/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Stage I non-small-cell lung cancer is potentially curable, yet older patients undergo treatment at lower rates than younger patients. This analysis sought to describe the treatment outcomes of nonagenarians with stage I non-small-cell lung cancer to better guide treatment decisions in this population. METHODS The National Cancer DataBase was queried for patients age ≥90 years old with stage I non-small-cell lung cancer (tumors ≤4 cm). Patients were divided into 3 groups: local therapy, other therapy, or no treatment. The primary outcomes were 5-year overall and relative survival. RESULTS Of the 616 patients identified, 33% (202) were treated with local therapy, 34% (207) were treated with other therapy, and 34% (207) underwent no treatment. Compared with local therapy, overall mortality was significantly higher with no treatment (hazard ratio 2.50, 95% confidence interval, 1.95-3.21) and other therapy (hazard ratio 1.43, 95% confidence interval, 1.11-1.83). The 5-year relative survival was 81% for local therapy, 49% for other therapy, and 32% for no treatment (P < .0001). CONCLUSION Nonagenarians managed with local therapy for stage I non-small-cell lung cancer (tumors ≤4 cm) have better overall survival than those receiving other therapy or no treatment and should be considered for treatment with either operation or stereotactic body radiation therapy if able to tolerate treatment.
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Affiliation(s)
- Brian N Arnold
- Section of Thoracic Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Daniel C Thomas
- Section of Thoracic Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Joshua E Rosen
- Section of Thoracic Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Michelle C Salazar
- Section of Thoracic Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Frank C Detterbeck
- Section of Thoracic Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Justin D Blasberg
- Section of Thoracic Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Daniel J Boffa
- Section of Thoracic Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Anthony W Kim
- Division of Thoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
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Gilbar PJ, Mutsando H, Richmond JP, Middleton RB. Cancer treatment in the extreme elderly: case study of a 100-year-old lymphoma patient. Int J Hematol Oncol 2016; 5:59-62. [PMID: 30302204 DOI: 10.2217/ijh-2016-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 07/18/2016] [Indexed: 11/21/2022] Open
Abstract
Limited data are available on the treatment of older adults with cancer. Comorbidities may preclude the administration of effective therapies, particularly in the extreme elderly. Comprehensive geriatric assessment can identify specific weaknesses of the patient and predict unexpected toxicities, thus enabling an optimized treatment strategy in this population. We report a case of the successful management of a 99-year-old female lymphoma patient with a strong wish for active treatment to improve quality of life and prolong survival past her 100th birthday. This case demonstrates that cancer treatment in the extreme elderly is possible and highlights the need for a formalized treatment plan based on geriatric assessment, frank discussion with patients and families, and defined goals of therapy.
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Affiliation(s)
- Peter J Gilbar
- Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,School of Medicine, University of Queensland, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,School of Medicine, University of Queensland, Toowoomba Hospital, Toowoomba, QLD 4350, Australia
| | - Howard Mutsando
- Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,School of Medicine, University of Queensland, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,School of Medicine, University of Queensland, Toowoomba Hospital, Toowoomba, QLD 4350, Australia
| | - Joshua P Richmond
- Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,School of Medicine, University of Queensland, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,School of Medicine, University of Queensland, Toowoomba Hospital, Toowoomba, QLD 4350, Australia
| | - Ronald B Middleton
- Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia.,Cancer & Palliative Care Services, Toowoomba Hospital, Toowoomba, QLD 4350, Australia
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Chargari C, Moriceau G, Auberdiac P, Guy JB, Assouline A, Tinquaut F, Falk AT, Eddekkaoui H, Bourmaud A, Coscas Y, Annede P, Rivoirard R, Mery B, Trone JC, Otmezguine Y, Pacaut C, Bauduceau O, Vedrine L, Merrouche Y, Magne N. Feasibility of radiation therapy in patients 90years of age and older: A French multicentre analysis. Eur J Cancer 2014; 50:1490-7. [DOI: 10.1016/j.ejca.2014.02.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
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Britt GJ, Gaughan EM, Nguyen KSH, Warner JL, Goldstein MA, Huberman MS, Costa DB. Case series of treatment approaches in fit nonagenarians with stage IV non-small-cell lung cancer. J Thorac Dis 2012; 3:141-3. [PMID: 22263078 DOI: 10.3978/j.issn.2072-1439.2011.03.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2011] [Indexed: 11/14/2022]
Abstract
An increasing number of nonagenarians are treated for non-small-cell lung cancer (NSCLC); however guidelines and case series describing the care of very elderly patients with advanced NSCLC are not available. Medical records of patients treated at Beth Israel Deaconess Medical Center between 2007 and 2009 who had NSCLC were reviewed, and those with stage IV NSCLC and age 90 or older were included in this case series. Three successive fit nonagenarians were identified out of the one hundred and one cases with stage IV NSCLC, and their clinical course was summarized. The first case depicts a conservative approach (best supportive care), while the later cases describe the use of platinum-based (carboplatin-pemetrexed) and anti-epidermal growth factor targeted therapies. This series illustrates the diversity of approaches now available and the evolving treatment paradigm as it applies to fit elderly with NSCLC, including nonagenarians. It also emphasizes the importance of considering performance status rather than biologic age when making treatment decisions.
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Affiliation(s)
- Gregory J Britt
- Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Abstract
PURPOSE: While quality of life is the focus of care in hospices, limited research has been conducted on the quality of life of cancer patients in hospice home care. The purpose of this study was to explore the predictors of quality of life of older adults who are receiving hospice care in their homes. METHODS: A secondary analysis of data from a larger study was conducted using linear regression and including the following predictor variables: age, functional status, number of symptoms endorsed, overall symptom distress, pain intensity, and depressive symptoms. The outcome variable was quality of life. RESULTS: The sample consisted of 533 adults with an average age of 78.1 years (SD=7.4). A regression model that included symptom distress, number of symptoms, depression, and functional status accounted for 46% of the variance in quality of life. Pain, age, and caregiver depression did not contribute to predicting quality of life and therefore were not included in the final model. CONCLUSIONS AND IMPLICATIONS: Because both physical symptoms and depression are predictors of quality of life, a continued focus is needed on these factors by those providing care to older adults with cancer near the end of life.
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