The Effect of A Geriatric Assessment on Treatment Decisions for Patients with Lung Cancer

• DOI: 10.1007/s00408-017-9983-7
• Publication Date: 2017-03-09T04:27:24Z
• Authors: Karlijn J. G. Sch...; Esteban T. D. Souwer; Marije E. Hamaker; Henk Codrington; Simone van der Sa...; Jan-Willem J. Lam...; Johanneke E. A. P...; Leontine J. R. va...; Frederiek van den...
• Keywords: Pulmonary and Respiratory Medicine; Aged, 80 and over; Male; Lung Neoplasms; Frailty; Health Status; Clinical Decision-Making; Nutritional Status; Comorbidity; Geriatric assessment; Article; 3. Good health; CGA; 03 medical and health sciences; 0302 clinical medicine; Pulmonary malignancies; Humans; Cognitive Dysfunction; Female; Mobility Limitation; Geriatric Assessment; Aged

Decision-making for older patients with lung cancer can be complex and challenging. A geriatric assessment (GA) may be helpful and is increasingly being used since 2005 when SIOG advised to incorporate this in standard work-up for the elderly with cancer. Our aim was to evaluate the value of a geriatric assessment in decision-making for patients with lung cancer.Between January 2014 and April 2016, data on patients with lung cancer from two teaching hospitals in the Netherlands were entered in a prospective database. Outcome of geriatric assessment, non-oncologic interventions, and suggested adaptations of oncologic treatment proposals were evaluated.83 patients (median age 79 years) were analyzed with a geriatric assessment, of which 59% were treated with a curative intent. Half of the patients were classified as ECOG PS 0 or 1. The majority of the patients (78%) suffered from geriatric impairments and 43% (n = 35) of the patients suffered from three or more geriatric impairments (out of eight analyzed domains). Nutritional status was most frequently impaired (52%). Previously undiagnosed impairments were identified in 58% of the patients, and non-oncologic interventions were advised for 43%. For 33% of patients, adaptations of the oncologic treatment were proposed. Patients with higher number of geriatric impairments more often were advised a reduced or less intensive treatment (p < 0.001).A geriatric assessment uncovers previously unknown health impairments and provides important guidance for tailored treatment decisions in patients with lung cancer. More research on GA-stratified treatment decisions is needed.