{"title":"Quality or quantity of life? Treatment priorities in older adults with cancer in the community.","authors":"Gabriel Aleixo, Julianne Ani, Ramy Sedhom","doi":"10.1093/oncolo/oyaf261","DOIUrl":null,"url":null,"abstract":"<p><p>Older adults with cancer often face decisions about prioritizing quality of life, survival, or both. In this prospective study of 181 patients aged ≥65 at a community cancer center, patients completed a geriatric assessment (GA) that included a validated trade-off question: \"Maintaining my quality of life is more important to me than living longer.\" Preferences were categorized as prioritizing quality of life, quantity of life, or both. Older age (OR 1.06; P = .04) and female sex (Odds Ratio 2.82; P = .01) were associated with prioritizing quality of life. Functional, cognitive, or psychosocial impairments were not. Prioritizing quality of life was not associated with worse overall survival (Hazard Ratio 1.06; P = .89). Receipt of standard treatment improved survival (HR 0.38; P = .04), while Performance status 3-4 predicted worse outcomes. These findings challenge assumptions that prioritizing quality of life compromises survival and support the integration of GA and values-based discussions into cancer care.</p>","PeriodicalId":54686,"journal":{"name":"Oncologist","volume":" ","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449121/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/oncolo/oyaf261","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Older adults with cancer often face decisions about prioritizing quality of life, survival, or both. In this prospective study of 181 patients aged ≥65 at a community cancer center, patients completed a geriatric assessment (GA) that included a validated trade-off question: "Maintaining my quality of life is more important to me than living longer." Preferences were categorized as prioritizing quality of life, quantity of life, or both. Older age (OR 1.06; P = .04) and female sex (Odds Ratio 2.82; P = .01) were associated with prioritizing quality of life. Functional, cognitive, or psychosocial impairments were not. Prioritizing quality of life was not associated with worse overall survival (Hazard Ratio 1.06; P = .89). Receipt of standard treatment improved survival (HR 0.38; P = .04), while Performance status 3-4 predicted worse outcomes. These findings challenge assumptions that prioritizing quality of life compromises survival and support the integration of GA and values-based discussions into cancer care.
患有癌症的老年人经常面临生活质量优先，生存或两者兼而有之的决定。在这项前瞻性研究中，来自社区癌症中心的181名年龄≥65岁的患者完成了一项老年评估，其中包括一个经过验证的权衡问题：“维持我的生活质量对我来说比活得更长更重要。”偏好分为生活质量优先，生活时间优先，或两者兼而有之。年龄（OR 1.06; p = 0.04）和女性（OR 2.82; p = 0.01）与优先考虑生活质量相关。功能、认知或心理障碍则没有。优先考虑生活质量与较差的总生存率无关（HR 1.06; p = 0.89）。接受标准治疗可提高生存率（HR 0.38; p = 0.04），而ECOG 3-4预测预后较差。这些发现挑战了优先考虑生活质量会损害生存的假设，并支持将老年评估和基于价值观的讨论整合到癌症治疗中。
期刊介绍：
The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.
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