International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer Hans Wildiers⇑, Pieter Heeren, Martine Puts, Eva Topinkova, Maryska L.G. Janssen-Heijnen, Martine Extermann, Claire Falandry, Andrew Artz, Etienne Brain, Giuseppe Colloca, Johan Flamaing, Theodora Karnakis, Cindy Kenis, Riccardo A. Audisio, Supriya Mohile, Lazzaro Repetto, Barbara Van Leeuwen, Koen Milisen and Arti Hurria + Author Affiliations

Hans Wildiers, Pieter Heeren, Johan Flamaing, Cindy Kenis, and Koen Milisen, University Hospitals Leuven, KU Leuven, Leuven, Leuven, Belgium; Martine Puts, University of Toronto, Toronto, Ontario, Canada; Eva Topinkova, Charles University, Prague, Czech Republic; Maryska L.G. Janssen-Heijnen, VieCuri Medical Centre, Venlo, and Maastricht University Medical Center, Maastricht; Barbara Van Leeuwen, Groningen University, Groningen, the Netherlands; Martine Extermann, University of South Florida, Tampa, FL; Claire Falandry, Lyon University, Pierre-Bénite; Etienne Brain, Hôpital René Huguenin–Institut Curie, Saint-Cloud, France; Andrew Artz, University of Chicago, Chicago, IL; Giuseppe Colloca, Catholic University of Sacred Heart, Rome; Lazzaro Repetto, G. Borea Hospital, Sanremo, Italy; Theodora Karnakis, University of Sao Paulo Medical School, Sao Paulo, Brazil; Riccardo A. Audisio, University of Liverpool, Liverpool, United Kingdom; Supriya Mohile, University of Rochester, Rochester, NY; and Arti Hurria, City of Hope, Duarte, CA. Corresponding author: Hans Wildiers, MD, PhD, Department General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; e-mail: hans.wildiers@uzleuven.be. H.W. and P.H. contributed equally to this work.

Abstract

Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer.

Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care.

Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another.

Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base.

http://jco.ascopubs.org/content/early/2014/07/28/JCO.2013.54.8347.abstract