Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer
Por:
Feliu J, Pinto A, Basterretxea L, López-San Vicente B, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Espinosa E, Gironés R, Custodio AB, Muñoz MDM, Díaz-Almirón M, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O, González-Montalvo JI and Molina-Garrido MJ
Publicada:
1 abr 2021
Ahead of Print:
10 abr 2021
Categoría:
Medicine (miscellaneous)
Resumen:
Background: Estimation of life expectancy in older patients is relevant to select the best treatment strategy. We aimed to develop and validate a score to predict early mortality in older patients with cancer. Patients and Methods: A total of 749 patients over 70 years starting new chemotherapy regimens were prospectively included. A prechemotherapy assessment that included sociodemographic variables, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and early death was examined using multivariable logistic regression. Score points were assigned to each risk factor. External validation was performed on an independent cohort. Results: In the training cohort, the independent predictors of 6-month mortality were metastatic stage (OR 4.8, 95% CI [2.4-9.6]), ECOG-PS 2 (OR 2.3, 95% CI [1.1-5.2]), ADL <= 5 (OR 1.7, 95% CI [1.1-3.5]), serum albumin levels <= 3.5 g/dL (OR 3.4, 95% CI [1.7-6.6]), BMI < 23 kg/m(2) (OR 2.5, 95% CI [1.3-4.9]), and hemoglobin levels < 11 g/dL (OR 2.4, 95% CI (1.2-4.7)). With these results, we built a prognostic score. The area under the ROC curve was 0.78 (95% CI, 0.73 to 0.84), and in the validation set, it was 0.73 (95% CI: 0.67-0.79). Conclusions: This simple and highly accurate tool can help physicians making decisions in elderly patients with cancer who are planned to initiate chemotherapy treatment.
Filiaciones:
Feliu J:
Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain
Pinto A:
Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain
Basterretxea L:
Oncology Department, OSI Donostialde, Donostia Unibertsitate Ospitalea, Donostialde, Donostia, 20014 Gipuzkoa, Spain
López-San Vicente B:
Oncology Department, OSI Bilbao, 48013 Bilbao, Spain
:
Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain
Llabrés E:
Oncology Department, Hospital Universitario Insular de Gran Canarias, 35016 Las Palmas, Spain
Jiménez-Munárriz B:
Oncology Department, Centro Integral Oncológico Clara Campal, 28050 Madrid, Spain
Antonio-Rebollo M:
Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL, Hospitalet, 08908 Barcelona, Spain
Losada B:
Oncology Department, Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain
Espinosa E:
Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain
Gironés R:
Oncology Department, Hospital Universitari y Politécnic La Fé, 46026 Valencia, Spain
Custodio AB:
Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain
Muñoz MDM:
Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
Díaz-Almirón M:
Biostatistics Department, Hospital La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain
Gómez-Mediavilla J:
Oncology Department, OSI Donostialde, Donostia Unibertsitate Ospitalea, Donostialde, Donostia, 20014 Gipuzkoa, Spain
:
Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain
Soler G:
Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL, Hospitalet, 08908 Barcelona, Spain
Cruz P:
Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain
Higuera O:
Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain
González-Montalvo JI:
Geriatric Department, Hospital Universitario La Paz, IDIPAZ, 28046 Madrid, Spain
Molina-Garrido MJ:
Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
Green Published, gold
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