Geriatric Assessment and Functional Decline in Older Patients with Lung Cancer
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Older patients with lung cancer are a heterogeneous population making treatment decisions complex. This study aims to evaluate the value of geriatric assessment (GA) as well as the evolution of functional status (FS) in older patients with lung cancer, and to identify predictors associated with functional decline and overall survival (OS).
At baseline, GA was performed in patients ≥70 years with newly diagnosed lung cancer. FS measured by activities of daily living (ADL) and instrumental activities of daily living (IADL) was reassessed at follow-up to define functional decline and OS was collected. Predictors for functional decline and OS were determined.
Two hundred and forty-five patients were included in this study. At baseline, GA deficiencies were present in all domains and ADL and IADL were impaired in 51 and 63% of patients, respectively. At follow-up, functional decline in ADL was observed in 23% and in IADL in 45% of patients. In multivariable analysis, radiotherapy was predictive for ADL decline. No other predictors for ADL or IADL decline were identified. Stage and baseline performance status were predictive for OS.
Older patients with lung cancer present with multiple deficiencies covering all geriatric domains. During treatment, functional decline is observed in almost half of the patients. None of the specific domains of the GA were predictive for functional decline or survival, probably because of the high impact of the aggressiveness of this tumor type leading to a poor prognosis.
KeywordsOlder Lung cancer Geriatric assessment Functional decline
This research was funded by the National Cancer Plan, action 24 of the Belgian Government.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no competing interests.
- 1.SEER cancer statistics factsheets: lung and bronchus cancer. National Cancer Institute. Bethesda. http://seer.cancer.gov/statfacts/html/lungb.html
- 12.Kenis C, Flamaing J, Debruyne PR et al (2015) A nationwide implementation of a multidisciplinary geriatric assessment and intervention program in Belgian older patients with cancer. J Geriatr Oncol 6(suppl 1):S13Google Scholar
- 22.Corre R, Greillier L, Le Caër H, Audigier-Valette C, Baize N, Bérard H et al (2016) Use of a comprehensive geriatric assessment for the management of elderly patients with advanced non-small-cell lung cancer: the phase III randomized ESOGIA-GFPC-GECP 08-02 study. J Clin Oncol 34:1476–1483CrossRefPubMedGoogle Scholar
- 28.Maione P, Perrone F, Gallo C, Manzione L, Piantedosi FV, Barbera S et al (2005) Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced NSCLC receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study. J Clin Oncol 23:6865–6872CrossRefPubMedGoogle Scholar
- 29.Pallis AG, Gridelli C, Wedding U, Faivre-Finn C, Veronesi G, Jaklitsch M et al (2014) Management of elderly patients with NSCLC updated expert’s opinion paper: EORTC elderly task force, lung cancer group and international society for geriatric oncology. Ann Oncol 25:1270–1283CrossRefPubMedGoogle Scholar