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Geriatric Assessment-Guided Care Processes for Older Adults: A Delphi Consensus of Geriatric Oncology Experts

Supriya Gupta Mohile, Carla Velarde, Arti Hurria, Allison Magnuson, Lisa Lowenstein, Chintan Pandya, Anita O'Donovan, Rita Gorawara-Bhat, and William Dale

reduction in morbidity and mortality and improvement in quality of life. In geriatric oncology, care processes use GA in 2 distinct, but related, ways. First, GA is used to identify specific evidence-based geriatric interventions to be implemented, such as

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Geriatric Oncology Education for the Oncologist is Overdue

Beatriz Korc-Grodzicki

developed by Maggiore et al 6 showed that a minority of fellows had access to geriatric oncology clinical experiences, lectures, or educational resources, and reported a lack of confidence in key geriatric oncology skills. In addition, many of the fellows

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The Future of Geriatric Oncology Research: Moving Toward Interventions and Objective Biomarkers of Aging

Efrat Dotan

Significant progress has been made in the field of geriatric oncology in recent years with the development and validation of a cancer-specific geriatric assessment (GA), establishing chemotherapy toxicity prediction tools, and geriatric screening

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Research Priorities in Geriatric Oncology: Addressing the Needs of an Aging Population

Arti Hurria, Supriya Gupta Mohile, and William Dale

that affect older patients. Consequently, little evidence-based data are available on the care of the growing number of older adults with cancer. To bridge this gap, a U13 conference grant, “Geriatric Oncology Research to Improve Clinical Care

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Frailty After Cancer Surgery Among Older Adults: A Geriatric Oncology Perspective

Samuel Dubé and Shabbir M.H. Alibhai

. Dubé is a former Geriatric Oncology Fellow at the University of Toronto and has a special interest in the care of older adults with cancer. SHABBIR M.H. ALIBHAI, MD, MSc Shabbir M.H. Alibhai, MD, MSc, is a geriatric oncologist and health

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Electronic Rapid Fitness Assessment: A Novel Tool for Preoperative Evaluation of the Geriatric Oncology Patient

Armin Shahrokni, Amy Tin, Robert J. Downey, Vivian Strong, Sanam Mahmoudzadeh, Manpreet K. Boparai, Sincere McMillan, Andrew Vickers, and Beatriz Korc-Grodzicki

International Society of Geriatric Oncology found that only 6% of clinicians used GA in daily practice, and only 34% collaborated with geriatricians. 15 These poor compliance rates likely stem from the practical difficulties of implementing GA in routine

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Psychological Issues in Geriatric Oncology

Archna Sarwal and Andrew J. Roth

Optimism about improved survival from cancer has increased. However, even with tremendous improvements in screening techniques and treatment, a cancer diagnosis may shatter the dream of a dignified old age for elderly patients. Cancer diagnosis and treatment often produce psychological stresses resulting from the actual symptoms of the disease, as well as the patient and family's perceptions of the disease and its stigma. Concerns related to cancer have particular meaning for aging individuals who undergo these situations in the context of retirement, widowhood, other medical disabilities, and other losses. Today, patients and families are more interested in treatment issues and quality of life, both during and after treatment. In this article we discuss late life depression, anxiety, and delirium and treatments related to elderly patients coping with cancer.

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External Validation of Risk Factors for Unplanned Hospitalization in Older Adults With Advanced Cancer Receiving Chemotherapy

Mostafa R. Mohamed, Kah Poh Loh, Supriya G. Mohile, Michael Sohn, Tracy Webb, Megan Wells, Sule Yilmaz, Rachael Tylock, Eva Culakova, Allison Magnuson, Can-Lan Sun, James Bearden, Judith O. Hopkins, Bryan A. Faller, and Heidi D. Klepin

Background: Older adults (age ≥65 years) receiving chemotherapy are at risk for hospitalization. Predictors of unplanned hospitalization among older adults receiving chemotherapy for cancer were recently published using data from a study conducted by the Cancer and Aging Research Group (CARG). Our study aimed to externally validate these predictors in an independent cohort including older adults with advanced cancer receiving chemotherapy. Methods: This validation cohort included patients (n=369) from the GAP70+ trial usual care arm. Enrolled patients were aged ≥70 years with incurable cancer and were starting a new line of chemotherapy. Previously identified risk factors proposed by the CARG study were ≥3 comorbidities, albumin level <3.5 g/dL, creatinine clearance <60 mL/min, gastrointestinal cancer, ≥5 medications, requiring assistance with activities of daily activities (ADLs), and having someone available to take them to the doctor (ie, presence of social support). The primary outcome was unplanned hospitalization within 3 months of treatment initiation. Multivariable logistic regression was applied including the 7 identified risk factors. Discriminative ability of the fitted model was performed by calculating the area under the receiver operating characteristic (AUC) curve. Results: Mean age of the cohort was 77 years, 45% of patients were women, and 29% experienced unplanned hospitalization within the first 3 months of treatment. The proportions of hospitalized patients with 0–3, 4–5, and 6–7 identified risk factors were 24%, 28%, and 47%, respectively (P=.04). Impaired ADLs (odds ratio, 1.76; 95% CI, 1.04–2.99) and albumin level <3.5 g/dL (odds ratio, 2.23; 95% CI, 1.37–3.62) were significantly associated with increased odds of unplanned hospitalization. The AUC of the model, including the 7 identified risk factors, was 0.65 (95% CI, 0.59–0.71). Conclusions: The presence of a higher number of risk factors was associated with increased odds of unplanned hospitalization. This association was largely driven by impairment in ADLs and low albumin level. Validated predictors of unplanned hospitalization can help with counseling and shared decision-making with patients and their caregivers.

ClinicalTrials.gov identifier: NCT02054741

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Determining Chemotherapy Tolerance in Older Patients With Cancer

Jerome Kim and Arti Hurria

-related complications. The National Cancer Institute and the National Institute on Aging, recognizing the current knowledge gaps in geriatric oncology, have called for studies to identify patients at high risk for chemotherapy intolerance in order to facilitate

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Older Patients, Cognitive Impairment, and Cancer: An Increasingly Frequent Triad

Martine Extermann

and patterns of care in older patients with cognitive impairment . 5th meeting of the International Society of Geriatric Oncology , San Francisco , October 15–16, 2004 . 4 Chodosh J Petitti DB Elliott M . Physician recognition of