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Geriatric Assessment and Functional Decline in Older Patients with Lung Cancer

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Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

This research was funded by the National Cancer Plan, action 24 of the Belgian Government.

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Authors and Affiliations

  1. Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    L. Decoster, D. Schallier, L. Vanacker & J. De Grève

  2. Department of General Medical Oncology, University Hospitals Leuven, Louvain, Belgium

    C. Kenis & H. Wildiers

  3. Department of Geriatric Medicine, University Hospitals Leuven, Louvain, Belgium

    C. Kenis & J. Flamaing

  4. Department of Respiratory Oncology, University Hospitals Leuven, Louvain, Belgium

    J. Vansteenkiste & K. Nackaerts

  5. Department of Geriatric Medicine, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium

    N. Vandewalle

  6. Department of Clinical and Experimental Medicine, KU Leuven, Louvain, Belgium

    J. Flamaing

  7. Consultant in Statistics, Beernem, Belgium

    J. P. Lobelle

  8. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Louvain, Belgium

    K. Milisen

  9. Department of Oncology, KU Leuven, Louvain, Belgium

    H. Wildiers

Authors
  1. L. Decoster
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  2. C. Kenis
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  3. D. Schallier
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  4. J. Vansteenkiste
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  5. K. Nackaerts
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  6. L. Vanacker
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  7. N. Vandewalle
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  8. J. Flamaing
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  9. J. P. Lobelle
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  10. K. Milisen
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  11. J. De Grève
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  12. H. Wildiers
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Corresponding author

Correspondence to L. Decoster.

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Decoster, L., Kenis, C., Schallier, D. et al. Geriatric Assessment and Functional Decline in Older Patients with Lung Cancer. Lung 195, 619–626 (2017). https://doi.org/10.1007/s00408-017-0025-2

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  • DOI: https://doi.org/10.1007/s00408-017-0025-2

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