Geriatric assessments refine cancer treatment in elderly, lead to better outcomes

Geriatric assessment (GA) may help lower complication rate and length of stay among older patients with cancer without affecting 1-year mortality, a recent study has found.

Researchers retrospectively assessed 184 elderly patients with solid malignancies who had been referred to a surgical outpatient clinic. All participants underwent a nurse-led GA, the findings from which were incorporated in the discussions of an onco-geriatric multidisciplinary team (MDT) and could lead to modifications in management.

The study outcomes were 1-year all-cause mortality, postoperative complications and hospital length of stay, compared between groups that have had their management plans modified or unchanged.

Overall, 25 percent (n=46) saw modifications in their cancer management plans, while the approach was unchanged in 75 percent (n=138). One-year all-cause mortality was 28.8 percent for the overall sample and did not differ between the former and latter subgroups of patients (26.1 percent vs 29.7 percent, respectively; p=0.7).

Meanwhile, adjustments made by the MDT had a significant impact on postoperative complication rate, which was significantly lower in those whose management plans had been modified (13.0 percent vs 34.8 percent; p=0.005). In this overall analysis, needing no surgery was counted as having no complications. In the subgroup of patients who had undergone surgery, treatment modification had no impact on complication rate (p=0.2).

In addition, the researchers found that patients who had had their management plans adjusted stayed for a significantly shorter time than those whose care was unchanged (median, 5 vs 8.5 days; p=0.0020).

“[I]ncorporating geriatric assessment in treatment decision-making improved patient outcomes, without increasing one-year mortality rate. These data support broader implementation of geriatric assessment in oncology care,” the researchers said.