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Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry
PURPOSE: Predicting feasibility of treatment in older patients with cancer is a major clinical task. The Initiative Geriatrische Hämatologie und Onkologie (IN-GHO(®)) registry prospectively collected data on the comprehensive geriatric assessment (CGA), physician’s and patient’s-self assessment of f...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484105/ https://www.ncbi.nlm.nih.gov/pubmed/34312732 http://dx.doi.org/10.1007/s00432-021-03714-3 |
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author | Honecker, Friedemann Huschens, Susanne Angermund, Ralf Kallischnigg, Gerd Freier, Werner Friedrich, Christoph Hartung, Gerold Lutz†, Arnulf Otremba, Burkhard Pientka, Ludger Späth-Schwalbe, Ernst Kolb, Gerald Bokemeyer, Carsten Wedding, Ulrich |
author_facet | Honecker, Friedemann Huschens, Susanne Angermund, Ralf Kallischnigg, Gerd Freier, Werner Friedrich, Christoph Hartung, Gerold Lutz†, Arnulf Otremba, Burkhard Pientka, Ludger Späth-Schwalbe, Ernst Kolb, Gerald Bokemeyer, Carsten Wedding, Ulrich |
author_sort | Honecker, Friedemann |
collection | PubMed |
description | PURPOSE: Predicting feasibility of treatment in older patients with cancer is a major clinical task. The Initiative Geriatrische Hämatologie und Onkologie (IN-GHO(®)) registry prospectively collected data on the comprehensive geriatric assessment (CGA), physician’s and patient’s-self assessment of fitness for treatment, and the course of treatment in patients within a treatment decision aged ≥ 70 years. PATIENTS AND METHODS: The registry included 3169 patients from 93 centres and evaluated clinical course and treatment outcomes 2–3 and 6 months after initial assessment. Fitness for treatment was classified as fit, compromised and frail according to results of a CGA, and in addition by an experienced physician’s and by patient’s itself. Feasibility of treatment (termed IN-GHO(®)-FIT) was defined as a composite endpoint, including willingness to undergo the same treatment again in retrospect, no modification or unplanned termination of treatment, and no early mortality (within 90 days). RESULTS: CGA classified 30.0% as fit, 35.8% as compromised, and 34.2% as frail. Physician’s and patient’s-self assessment classified 61.8%/52.3% as fit, 34.2%/42.4% as compromised, and 3.9%/5.3%, as frail, respectively. Survival status at day 180 was available in 2072 patients, of which 625 (30.2%) had died. After 2–3 months, feasibility of treatment could be assessed in 1984 patients. 62.8% fulfilled IN-GHO®-FIT criteria. Multivariable analysis identified physician’s assessment as the single most important item regarding feasibility of treatment. CONCLUSION: Geriatricians were involved in 2% of patients only. Classification of fitness for treatment by CGA, and physician’s or patient’s-self assessment showed marked discrepancies. For the prediction of feasibility of treatment no single item was superior to physician’s assessment. However CGA was not performed by trained geriatricians. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00432-021-03714-3. |
format | Online Article Text |
id | pubmed-8484105 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-84841052021-10-08 Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry Honecker, Friedemann Huschens, Susanne Angermund, Ralf Kallischnigg, Gerd Freier, Werner Friedrich, Christoph Hartung, Gerold Lutz†, Arnulf Otremba, Burkhard Pientka, Ludger Späth-Schwalbe, Ernst Kolb, Gerald Bokemeyer, Carsten Wedding, Ulrich J Cancer Res Clin Oncol Original Article – Cancer Research PURPOSE: Predicting feasibility of treatment in older patients with cancer is a major clinical task. The Initiative Geriatrische Hämatologie und Onkologie (IN-GHO(®)) registry prospectively collected data on the comprehensive geriatric assessment (CGA), physician’s and patient’s-self assessment of fitness for treatment, and the course of treatment in patients within a treatment decision aged ≥ 70 years. PATIENTS AND METHODS: The registry included 3169 patients from 93 centres and evaluated clinical course and treatment outcomes 2–3 and 6 months after initial assessment. Fitness for treatment was classified as fit, compromised and frail according to results of a CGA, and in addition by an experienced physician’s and by patient’s itself. Feasibility of treatment (termed IN-GHO(®)-FIT) was defined as a composite endpoint, including willingness to undergo the same treatment again in retrospect, no modification or unplanned termination of treatment, and no early mortality (within 90 days). RESULTS: CGA classified 30.0% as fit, 35.8% as compromised, and 34.2% as frail. Physician’s and patient’s-self assessment classified 61.8%/52.3% as fit, 34.2%/42.4% as compromised, and 3.9%/5.3%, as frail, respectively. Survival status at day 180 was available in 2072 patients, of which 625 (30.2%) had died. After 2–3 months, feasibility of treatment could be assessed in 1984 patients. 62.8% fulfilled IN-GHO®-FIT criteria. Multivariable analysis identified physician’s assessment as the single most important item regarding feasibility of treatment. CONCLUSION: Geriatricians were involved in 2% of patients only. Classification of fitness for treatment by CGA, and physician’s or patient’s-self assessment showed marked discrepancies. For the prediction of feasibility of treatment no single item was superior to physician’s assessment. However CGA was not performed by trained geriatricians. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00432-021-03714-3. Springer Berlin Heidelberg 2021-07-26 2021 /pmc/articles/PMC8484105/ /pubmed/34312732 http://dx.doi.org/10.1007/s00432-021-03714-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article – Cancer Research Honecker, Friedemann Huschens, Susanne Angermund, Ralf Kallischnigg, Gerd Freier, Werner Friedrich, Christoph Hartung, Gerold Lutz†, Arnulf Otremba, Burkhard Pientka, Ludger Späth-Schwalbe, Ernst Kolb, Gerald Bokemeyer, Carsten Wedding, Ulrich Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry |
title | Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry |
title_full | Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry |
title_fullStr | Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry |
title_full_unstemmed | Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry |
title_short | Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO(®) Registry |
title_sort | patient assessment and feasibility of treatment in older patients with cancer: results from the in-gho(®) registry |
topic | Original Article – Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484105/ https://www.ncbi.nlm.nih.gov/pubmed/34312732 http://dx.doi.org/10.1007/s00432-021-03714-3 |
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