Bakker, Tjitske (2020) The predictive value of geriatric screening compared to performance status assessment by a clinician on unwanted treatment outcomes in older patients with cancer An observational cohort study. thesis, Medicine.
Full text available on request.Abstract
Background: Older cancer patients are a very heterogeneous population. In current clinical practice, the WHO performance score (WHO-PS) is commonly used to distinguish fit and frail patients in order to make treatment decisions. Another, more objective way of identifying patients who are at risk for unwanted treatment outcomes is Geriatric screening (GS). Research questions: How many older patients with cancer are judged frail according to WHO-PS by the treating clinician, compared to the number of patients screened potentially frail with GS consisting of the G8 and 6CIT? What is the predictive value of GS compared to WHO-PS on mortality, quality of life and functional decline after treatment in older patients with cancer? Methods: In this prospective cohort study, patients ≥70, presenting with a malign process that possibly needed treatment and who received a WHO-PS in their medical records from one of their treating clinicians were included. At baseline, GS (consisting of G8 and 6CIT) and full geriatric assessment were conducted. We compared the amount of patients screened positive with GS and the amount of patients judged frail according to the WHO-PS. Additionally, we compared the predictive value on mortality, functional decline and loss of quality of life within 12 months follow up of both measures. Results: 130 patients were included. 34.6% was judged frail by the WHO-PS, while 61.5% was judged potentially frail by GS. WHO-PS and GS select different patients as (potentially) frail (p=.017). GS showed to be a better independent predictor for mortality within 12 months follow up than WHO-PS, where an abnormal score on GS strongly increases the risk of dying (HR 2.537, 95% CI .986-6.651, p=.058) and WHO-PS not (HR 1.588, 95% CI .611-4.127, p=.343). On the other hand, WHO-PS seems to have a stronger association with both functional decline and loss of quality of live over time, although not significant. Conclusion: GS is of added value to WHO-PS in making treatment decisions. Larger studies are needed to assess the predictive value of GS and WHO-PS on unwanted treatment outcomes.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | van Munster, prof. B. C. and van Holstein MSc, Y. and Trompet, Dr. S. |
| Faculty: | Medical Sciences |
| Date Deposited: | 09 Aug 2023 11:03 |
| Last Modified: | 09 Aug 2023 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3618 |
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