Submission To Be Reviewed
Title: A clinical pathway model for the elderly with cancer: outcomes in a series of 75 years old and older patients
Objective: to describe the outcomes of the older cancer patient referred to our hospital ward and following a specific institutional clinical pathway model.
Study design: comparative prospective cohort study.
Methods: from February 2016 to August 2017 all 75 old and older patients were assessed by G8 screening test. If the G8 score was > 14 they were considered as fit and eligible for any standard treatment. In case the G8 score was < 14, they were later assessed by a geriatrician according to CGA (Comprehensive Geriatric Assessment). Following this evaluation they were classified as unfit (intermediate functional condition) or frail, and they were considered eligible for modified cancer therapy, or only for palliative care, respectively.
Results: 140 patients were enrolled (76 men, 64 women; median age 81,6). The most frequent cancers were colon (22,9%), breast (18.9%) prostate (11.5%) and lung cancer (7.5%).
40 patients (28.6%) were classified fit, and 100 (71.4%) unfit/frail.
Seven (7%) of these 100 patients refused the CGA evaluation, and, of the remaining 93 patients, 64 (68.8%) were classified unfit and 29 (31.2%) frail.
A total of 61 fit/unfit patients underwent chemotherapy (19 fit and 42 unfit), while frail patients underwent palliative care. Eight toxicities over grade 2 occurred, two haematological toxicities in fit patients, and six (haematological, gastroenteric and cutaneous toxicities) in unfit patients.
Conclusions: the above reported care pathway model could be suitable in order to select the more convenient modality of approach for the elderly patient with cancer
Comprehensive Geriatric Assessment, G8, Older
Editor's request 09-08-2018
REVIEW FORM RESPONSE