Geriatric Clinic, Department of Medical Science, University of Padova, Via Giustininani 2, 35128 Padova, Italy.
J Geriatr Oncol. 2013 Jul;4(3):208-17. doi: 10.1016/j.jgo.2013.04.008. Epub 2013 May 24.
Despite the lack of definitive data on the impact of Comprehensive Geriatric Assessment (CGA) in the geriatric oncology setting, the broad use of any form of CGA is strongly recommended before any treatment decision in elderly cancer patients (ECP); currently there is no consensus about the best format for this geriatric assessment. The aim of this study was to firstly test the Multidimensional Prognostic Index (MPI) in ECP with locally advanced or metastatic disease.
Patients aged ≥70years with inoperable or metastatic solid cancer consecutively admitted to our Program of Geriatric Oncology were assessed by a multidisciplinary team and received a basal CGA to calculate the MPI score.
A hundred and sixty patients entered the study. In the Cox's regression model, MPI, CIRS-SI, BSA, GDS, MMSE, chemotherapy and a diagnosis of primary lung cancer were associated with mortality at 6 and 12months. The ROC curves confirmed the prognostic value of MPI, with the best discriminatory power for mortality at both 6 and 12months.
The present study is the first to indicate that the MPI retains its prognostic value even in elderly cancer patients with advanced stage of disease. The CIRS-SI and the GDS may potentiate the prognostic value of MPI.
尽管在老年肿瘤学背景下，全面老年评估（CGA）的影响缺乏明确的数据，但强烈建议在为老年癌症患者（ECP）做出任何治疗决策之前，都要进行任何形式的 CGA；目前，对于这种老年评估的最佳形式尚无共识。本研究的目的首先是测试多维预后指数（MPI）在局部晚期或转移性疾病的 ECP 中的应用。
连续收治于我们老年肿瘤学计划的年龄≥70 岁、不可手术或转移性实体癌患者，由多学科团队进行评估，并进行基础 CGA 以计算 MPI 评分。
160 名患者进入研究。在 Cox 回归模型中，MPI、CIRS-SI、BSA、GDS、MMSE、化疗和原发性肺癌诊断与 6 和 12 个月时的死亡率相关。ROC 曲线证实了 MPI 的预后价值，其在 6 和 12 个月时对死亡率的区分能力最佳。
本研究首次表明，即使在疾病晚期的老年癌症患者中，MPI 也保持其预后价值。CIRS-SI 和 GDS 可能增强 MPI 的预后价值。
