Prognostic value of geriatric assessment in older patients with advanced breast cancer receiving chemotherapy

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• 作者：A.A. Aaldriks ; E.J. Giltay ; S. le Cessie ; L.G.M. van der Geest ; J.E.A. Portielje ; B.C. Tanis ; J.W.R. Nortier ; E. Maartense
• 关键词：Breast cancer ; Geriatric assessment ; Elderly ; Chemotherapy
• 刊名：The Breast
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：22
• 期：5
• 页码：753-760
• 全文大小：567 K

文摘

Introduction

The prognostic value of geriatric assessment in older patients with breast cancer treated with chemotherapy is largely unknown.

Methods

Fifty-five patients with advanced breast cancer aged 70 years or older were assessed by Mini Nutritional Assessment (MNA), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Groningen Frailty Indicator (GFI) and Mini Mental State Examination (MMSE). Levels of albumin, hemoglobin, creatinine and lactate dehydrogenase were measured. Patients completing at least four cycles of chemotherapy were reassessed by GFI and MMSE and mortality was evaluated using Cox regression analysis.

Results

The mean age was 76 year (SD 4.8). Inferior MNA and GFI scores were associated with increased hazard ratios for mortality: 3.05 (95 % confidence interval [CI]: 1.44-6.45; p?=?0.004) and 3.40 (95 % CI: 1.62-7.10; p?=?0.001), respectively. Physical aspects of frailty worsened during the course of chemotherapy. Laboratory values were not associated with assessment scores nor were they predictive for mortality.

Conclusions

Malnutrition and frailty, rather than cognitive impairment and laboratory values, were associated with an increased mortality risk in these elderly breast cancer patients with advanced breast cancer.