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Impact of an oncogeriatric consulting team on therapeutic decision-making

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The journal of nutrition, health & aging

Abstract

Increased life expectancy and cancer incidence imply the need to develop a specialized care policy for elderly patients with cancer. We created an oncogeriatric consulting team (OGCT) in Toulouse University Hospital to carry out comprehensive gerontological assessment at the bedside of hospitalized patients. We analyze the impact on the final cancer treatment decision of this mobile geriatric assessment. We carried out a descriptive, retrospective real-life analysis of a patient cohort over a two-year period. The OGCT assessed 124 patients, of whom the majority were women (54.8%), median age 81 years, living at home (95.2%) and with family caregivers (86.5%). Nearly all were frail (96.7% according to the classification of Balducci and colleagues) and 3.2% were vulnerable. The team’s decisions were analyzed for patients who had not yet been treated (n=107). After analysis, the team’s proposal was in line with the initial cancer treatment plan in 68.2% of cases (n=73). In cases where there was a disagreement, the final decision was in line with the mobile team’s proposal in 17.75% of 107 patients (n=19). The decision of the team was followed more often when their assessment proposed strictly palliative treatment. The decision to give elderly patients specific cancer treatment seems in our experience rather to be a matter for the oncologists, and is not very susceptible to modification by geriatric opinion. On the other hand, the geriatrician appears to be more credible and his/her opinion more likely to be followed when the patient is considered too frail and less aggressive, or even exclusively palliative, treatment is proposed.

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Authors and Affiliations

  1. Département Universitaire de Médecine Générale, Faculté Toulouse Rangueil, Toulouse, France

    Marie-Eve Rougé Bugat, N. Boussier & S. Oustric

  2. Gérontopôle, Service de Médecine Interne Gériatrique, CHU Toulouse Hôpital Casselardit, 170 avenue de Casselardit, 31300, Toulouse, France

    S. Gerard, L. Balardy, A. Perrin, B. Vellas & F. Nourhashemi

  3. Inserm U1027, Faculté de Médecine, 37 allées Jules Guesde, 31073, Toulouse, France

    Marie-Eve Rougé Bugat, B. Vellas & F. Nourhashemi

  4. Medecine Interne et immunopathologie, CHU Toulouse Purpan, Toulouse, France

    O. Beyne-Rauzy

  5. Cabinet Médical de la Providence, 59 rue de la Providence, 31500, Toulouse, France

    Marie-Eve Rougé Bugat

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  1. Marie-Eve Rougé Bugat
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Bugat, ME.R., Gerard, S., Balardy, L. et al. Impact of an oncogeriatric consulting team on therapeutic decision-making. J Nutr Health Aging 17, 473–478 (2013). https://doi.org/10.1007/s12603-012-0435-z

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  • DOI: https://doi.org/10.1007/s12603-012-0435-z

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