Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO® Registry
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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; Initiative Geriatrische Hämatologie und Onkologie (IN-GHO®).
In: J CANCER RES CLIN, Vol. 147, No. 11, 11.2021, p. 3183-3194.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO® Registry
AU - Honecker, Friedemann
AU - Huschens, Susanne
AU - Angermund, Ralf
AU - Kallischnigg, Gerd
AU - Freier, Werner
AU - Friedrich, Christoph
AU - Hartung, Gerold
AU - Lutz, Arnulf
AU - Otremba, Burkhard
AU - Pientka, Ludger
AU - Späth-Schwalbe, Ernst
AU - Kolb, Gerald
AU - Bokemeyer, Carsten
AU - Wedding, Ulrich
AU - Initiative Geriatrische Hämatologie und Onkologie (IN-GHO®).
N1 - © 2021. The Author(s).
PY - 2021/11
Y1 - 2021/11
N2 - 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.
AB - 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.
U2 - 10.1007/s00432-021-03714-3
DO - 10.1007/s00432-021-03714-3
M3 - SCORING: Journal article
C2 - 34312732
VL - 147
SP - 3183
EP - 3194
JO - J CANCER RES CLIN
JF - J CANCER RES CLIN
SN - 0171-5216
IS - 11
ER -
