The effect of a geriatric evaluation on treatment decisions and outcome for older cancer patients – A systematic review. Issue 5 (September 2018)

• Record Type: Journal Article
• Authors: Hamaker, Marije E.; te Molder, Marthe; Thielen, Noortje; van Munster, Barbara C.; Schiphorst, Anandi H.; van Huis, Lieke H.
• Is Part Of: Journal of geriatric oncology. Volume 9:Issue 5(2018)
• Page Start: 430
• Page End: 440
• Publication Date: 2018-09
• Subjects: Geriatric assessment and management -- Cancer -- Decision making -- Non-oncologic interventions -- Treatment outcome; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2018.03.014
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Aim: The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancer patients, focussing on oncologic treatment decisions, the implementation of non-oncologic interventions and the impact on treatment outcome. Methods: A systematic search in MEDLINE and EMBASE for studies on the effect of a geriatric evaluation on oncologic and non-oncologic treatment decisions and outcome for older cancer patients. Results: 36 publications from 35 studies were included. After a geriatric evaluation, the oncologic treatment plan was altered in a median of 28% of patients (range 8–54%), primarily to a less intensive treatment option. Non-oncologic interventions were recommended in a median of 72% of patients (range 26–100%), most commonly involving social issues (39%), nutritional status (32%) and polypharmacy (31%). Effect on treatment outcome was varying, with a trend towards a positive effect on treatment completion (positive effect in 75% of studies) and treatment-related toxicity/ complications (55% of studies). Conclusion: A geriatric evaluation affects oncologic and non-oncologic treatment and appears to improve treatment tolerance and completion for older cancer patients. Fine-tuning the decision-making process for this growing patient population will require more specific and robust data on the effect of a geriatric evaluation on relevant oncologic and non-oncologic outcomes such as survival and quality of life.