Journal of geriatric oncology最新文献

{"title":"Age-related disparities in survival following colorectal cancer diagnosis in an underserved community in Georgia: A retrospective cohort analysis","authors":"Meng-Han Tsai ,&nbsp;Jorge Cortes ,&nbsp;Elinita Pollard ,&nbsp;Marlo Vernon ,&nbsp;Yanbin Dong ,&nbsp;Kenneth J. Vega ,&nbsp;Steven S. Coughlin","doi":"10.1016/j.jgo.2025.102318","DOIUrl":"10.1016/j.jgo.2025.102318","url":null,"abstract":"<div><h3>Introduction</h3><div>Limited studies have examined disparities regarding age at diagnosis and 5-year overall survival (OS) following colorectal cancer (CRC) diagnosis within medically underserved areas in Georgia. The study aim was to examine this association and determine key factors of 5-year survival within four age groups in Augusta-Richmond County, Georgia.</div></div><div><h3>Materials and Methods</h3><div>We conducted a retrospective cohort analysis using 2012–2022 data from an institutional cancer registry linked with medical records and billing data from a single cancer center in Georgia. Multivariable Cox proportional hazard regression models were used.</div></div><div><h3>Results</h3><div>Among 839 patients with CRC, 5-year survival rates were lowest among patients aged 70+ years (54.9 % vs. 63.4 % for 60–69 years, 67.2 % for 50–59 years, and 67.4 % for 18–49 years) (<em>p</em> &lt; 0.001). Patients with CRC with a late stage at diagnosis were associated with increased risk of death by 2 to 7 times (18–49 years: HR, 5.45; 95 % CI, 2.28–10.55; 50–59 years: HR, 6.72; 95 % CI, 4.08–11.06; 60–69 years: HR, 5.98; 95 % CI, 3.92–9.10; 70+ years: HR, 2.21; 95 % CI, 1.41–3.46). Further, 50–59-year-old former smokers had an increased risk of death (HR, 2.16; 95 % CI, 1.11–4.20). Patients aged 60–69 years and living in persistent poverty areas also had an increased risk of death (HR, 1.85; 95 % CI, 1.20–2.85).</div></div><div><h3>Discussion</h3><div>Advanced diagnoses were associated with a greater risk of mortality regardless of age group. Former smokers and those living in persistent poverty areas were also linked to increased mortality for 50–59 and 60–69 age groups, respectively. Improving equitable access to screening facilities/ cancer treatment resources and promoting healthy lifestyles are critical.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102318"},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-to-lymphocyte ratio, a predictor for mortality and unplanned hospital readmissions in patients aged 75 years and older with cancer.","authors":"Giorgia Ceci Barcaglioni ,&nbsp;Julie Tisserand ,&nbsp;Simon Valero ,&nbsp;Patrick Bouchaert ,&nbsp;Mélanie Bouisset ,&nbsp;Emilie Favard ,&nbsp;Yvan Moreno ,&nbsp;Oriane Chauvineau ,&nbsp;Florent Seite ,&nbsp;Marc Paccalin ,&nbsp;Evelyne Liuu","doi":"10.1016/j.jgo.2025.102316","DOIUrl":"10.1016/j.jgo.2025.102316","url":null,"abstract":"<div><h3>Introduction</h3><div>Assessing the prognosis of older patients with cancer is essential to determine the best strategy for oncological care, given the heterogeneous profiles of this population. Evaluation should consider frailty, comorbidities, geriatric parameters, and oncological parameters. Finding early prognostic indicators would be helpful to optimize care. We aimed to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in patients aged 75 and above with solid cancers.</div></div><div><h3>Materials and Methods</h3><div>Retrospective review of the ANCRAGE (ANalyse CanceR et sujet AGE) cohort that included all patients ≥75 years of age with solid cancer who were consecutively assessed in the geriatric oncology clinic of the University Hospital of Poitiers (France) between January 1, 2016 and August 31, 2023. Pretreatment assessment included socio-demographic data, oncological, clinical frailty scale (CFS) and geriatric assessment (GA). Geriatric domains assessed were level of dependence, risk of falls, nutrition, mood, and cognition. We defined frailty as the presence of at least one impairment in any of the geriatric domains. The NLR was determined within seven days before or after the GA and before any specific cancer treatment. Survival curves and Cox regression analyses were performed to assess the prognostic values in terms of overall survival (OS) and unplanned hospital readmissions (UHR).</div></div><div><h3>Results</h3><div>Overall, 1446 patients were included. Mean age was 86.6 years (± 5.2 years), with a male predominance (59 %). Most prevalent cancer sites were prostate (20 %, <em>n</em> = 283), colorectal (16 %, <em>n</em> = 230), breast (15 %, <em>n</em> = 217), skin (9 %, <em>n</em> = 134), and lung (7 %, <em>n</em> = 103), with metastatic status in over one-third of cases. The pretreatment GA identified frailty in 70 % of cases (<em>n</em> = 1012), with malnutrition (54 %, <em>n</em> = 774) and risk of falls (37 %, <em>n</em> = 538) being the main contributing factors. Median NLR was 3.50 [2.34–5.31]. There was a significant association between NLR and frailty using the CFS score (<em>p</em> &lt; 0.001). The median follow-up time for OS analysis was 487 days [186–957]. The results of the multivariate analysis indicated that pretreatment NLR was an independent predictor of OS (hazard ratio [HR] 1.010, 95 % CI: 1.005–1.015, <em>p</em> &lt; 0.001) and of UHR (HR 1.057, 95 % CI: 1.014–1.101, <em>p</em> = 0.008). Cut-off value &gt;3.5 was associated with lower OS (p &lt; 0.001).</div></div><div><h3>Discussion</h3><div>In our study, NLR was independently associated with higher mortality and high risk of unplanned hospital readmissions within one year of GA in older patients with solid tumors.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102316"},"PeriodicalIF":3.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community oncologists' perspectives on hospice and palliative care for older adults with acute myeloid leukemia: A qualitative study","authors":"Mazie Tsang ,&nbsp;Maya Abdallah ,&nbsp;Heidi Klepin ,&nbsp;Kah Poh Loh","doi":"10.1016/j.jgo.2025.102314","DOIUrl":"10.1016/j.jgo.2025.102314","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102314"},"PeriodicalIF":3.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world ovarian cancer care and its survival impact on older adults: An observational study from the Australian National Gynae-Oncology Registry (NGOR)","authors":"Mahendra Naidoo ,&nbsp;Clare L. Scott ,&nbsp;Orla McNally ,&nbsp;Robert Rome ,&nbsp;Sharnel Perera ,&nbsp;John Zalcberg","doi":"10.1016/j.jgo.2025.102305","DOIUrl":"10.1016/j.jgo.2025.102305","url":null,"abstract":"<div><h3>Introduction</h3><div>Women aged ≥70 years with ovarian cancer (OC) may experience variations in care compared to best practice guidelines, and their five-year survival is significantly lower compared to women aged &lt;70 years. The National Gynae-Oncology Registry (NGOR) is Australia's first clinical quality registry (CQR) for gynaecological cancers, measuring patterns of care using 15 OC clinical quality indicators (CQIs) reflecting evidence-based practice. This study aimed to compare adherence to CQIs for older versus younger groups with newly diagnosed OC and evaluate differences in 5-year overall survival (OS).</div></div><div><h3>Materials and Methods</h3><div>This is a multi-centre, observational study utilizing NGOR data for women with newly diagnosed OC at participating sites (May 2017 to July 2022). Demographics, CQIs, and clinical variables were compared between women aged ≥70 years (older group) and those aged &lt;70 years (younger group). Five-year OS was estimated.</div></div><div><h3>Results</h3><div>A total of 1628 women were eligible. Median OS was 3.37 years (95 % CI: 3.05–3.86 years) in the ≥70 group versus not reached in the younger group aged &lt;70 (95 % CQI: 5.95 – n/a years). Compared to the younger group, older women less frequently received first-line platinum-taxane doublet chemotherapy (69.1 % vs 91.6 %, <em>p</em> &lt; 0.001) and first-line chemotherapy with a platinum-taxane doublet plus bevacizumab (18.9 % vs 29.9 %, <em>p</em> = 0.02). Older women were less likely to achieve primary surgery with no macroscopic residue (46.4 % vs 60.8 %, <em>p</em> = 0.03) and had lower clinical trial enrolment (15.5 % vs 21.7 %, <em>p</em> = 0.005). After adjusting for ECOG Performance Status, histological sub-type, cancer stage, and treatment group, five-year OS remained significantly lower in the older women with an adjusted HR for death 1.50 (95 % CI: 1.27–1.76, <em>p</em> = 0.001).</div></div><div><h3>Discussion</h3><div>Significant differences in care were observed in older women with OC, notably in achieving complete primary surgical cytoreduction, utilization of standard chemotherapy regimens, and trial enrolment. Survival for older women remains significantly lower than for younger women after adjustment. These findings highlight specific areas for potential quality improvement in the care of older Australian women with OC.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102305"},"PeriodicalIF":3.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing side-effect bother, burden, and tolerability: A qualitative study exploring the content validity of the Functional Assessment of Cancer Therapy – Item GP5","authors":"Nalin Payakachat ,&nbsp;Adrienne M. Gilligan ,&nbsp;Danielle Altman ,&nbsp;Patricia Maeda ,&nbsp;Julia Choi ,&nbsp;Shannon Bourke ,&nbsp;Rebecca M. Speck ,&nbsp;Erica Spies ,&nbsp;Katerina Kopeckova ,&nbsp;Rossella Elisei ,&nbsp;Jonathan Wadsley ,&nbsp;Jolanta Krajewska","doi":"10.1016/j.jgo.2025.102304","DOIUrl":"10.1016/j.jgo.2025.102304","url":null,"abstract":"<div><h3>Introduction</h3><div>Patient-reported measures of overall side effect burden such as the Functional Assessment of Cancer Therapy - item GP5 (GP5) can be used to assess the tolerability of cancer treatments. The single-item GP5, which reads “I am bothered by side effects of treatment,” has served as an endpoint in clinical trials. The objectives of this qualitative study were to explore how participants with medullary thyroid cancer (MTC) conceptualize side effect bother, burden, and tolerability and to generate evidence to support the GP5 as a fit-for-purpose measure of patient-reported tolerability in the treatment of MTC and to establish which response options constitute “high side effect burden.”</div></div><div><h3>Materials and Methods</h3><div>A purposive sample of 40 participants with MTC enrolled in the LIBRETTO-531 trial (<span><span>NCT04211337</span><svg><path></path></svg></span>) were recruited via clinical trial sites. Semi-structured interviews were conducted in the participant's preferred language to examine the concept of tolerability, demonstrate understanding of the GP5 content, and establish which response options constitute “high side effect burden.” Interview transcripts were thematically analyzed with a mix of inductive and deductive coding methods.</div></div><div><h3>Results</h3><div>In concept elicitation interviews, patients reported side effect bother as a highly relevant concept that was among the most proximal concepts to tolerability. The experience of side effects that are symptomatic and bothersome or burdensome are key contributors to how patients perceive the tolerability of a treatment. Cognitive interviewing showed the GP5 item was clear and understandable to all participants. Participants reported clear and concrete meaningful differences between each response option. Importantly, the qualitative data provide evidence that “high side effect burden” aligns with the response options of “Quite a bit” and “Very much” (score of 3 and 4, respectively) for most (60 %, <em>n</em> = 24) interview participants.</div></div><div><h3>Discussion</h3><div>Participants described the concepts of side effect bother, side effect burden, and tolerability as highly relevant and related. The GP5 assesses a concept important to individuals undergoing treatment for MTC in a way that is understandable and relevant. The definition of “high side effect burden” is appropriately reflected by scores of 3 or 4. This qualitative evidence is supportive of the GP5 as a fit-for-purpose measure of comparative tolerability in MTC.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102304"},"PeriodicalIF":3.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between low handgrip strength and mortality in older inpatients with cancer: A post hoc analysis of a cross-sectional randomized study","authors":"Pierre Sebag ,&nbsp;Cédric Villain ,&nbsp;Soazig Lebaube ,&nbsp;François Fournel ,&nbsp;Anaïs R. Briant ,&nbsp;Schroder Sattar ,&nbsp;Bérengère Beauplet","doi":"10.1016/j.jgo.2025.102312","DOIUrl":"10.1016/j.jgo.2025.102312","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102312"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the experiences and perceptions of cancer care treatment decision making for older people with cancer: A qualitative study","authors":"Sharon He ,&nbsp;Heather L. Shepherd ,&nbsp;Meera Agar ,&nbsp;Rebekah Laidsaar-Powell ,&nbsp;Joanne Shaw","doi":"10.1016/j.jgo.2025.102313","DOIUrl":"10.1016/j.jgo.2025.102313","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer becomes more common as people age. However, little is known about the cancer care experiences of older people. This paper aimed to qualitatively explore experiences and perceptions of older adults with cancer and carers on the impact of ageing on treatment decision-making and cancer care.</div></div><div><h3>Materials and Methods</h3><div>Self-identified older adults with cancer and independent carers of an older adult with cancer participated in a semi-structured telephone interview. Interviews were audio recorded and transcribed verbatim. Thematic analysis using a framework approach identified key themes.</div></div><div><h3>Results</h3><div>Nineteen older adults with cancer and nine carers participated. Patient participants had a mean age of 74 years (range 66–90 years), most were diagnosed with blood (<em>n</em> = 9) or breast (<em>n</em> = 8) cancer and had a mean time of 6 years since initial diagnosis. Majority of carers were female (<em>n</em> = 7), providing care for their spouse/partner (<em>n</em> = 6), with a mean age of 63.5 years (range 44–73 years). Thematic analysis identified three themes: (1) Impact of age in treatment decision-making: assumptions and discussions, (2) Factors that influenced patient treatment decisions, and (3) Cancer and ageing-related supports, encompassing the role of the carer and their capacity to provide support.</div></div><div><h3>Discussion</h3><div>This paper provides insights into the impact of age on cancer care for older adults and questions the underlying assumptions we have when considering an “older” adult and their treatment preferences. Results also highlight the importance of assessment and support for carers.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102313"},"PeriodicalIF":3.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare professionals' perspectives on improving care coordination between palliative and cancer care for rural older adults: A qualitative study","authors":"Shaowei Wan ,&nbsp;Jean M. Youngwerth ,&nbsp;Regina M. Fink ,&nbsp;Karl A. Lorenz ,&nbsp;Sarah E. Brewer ,&nbsp;Jean S. Kutner ,&nbsp;Jennifer Dickman Portz ,&nbsp;Stacy M. Fischer","doi":"10.1016/j.jgo.2025.102301","DOIUrl":"10.1016/j.jgo.2025.102301","url":null,"abstract":"<div><h3>Introduction</h3><div>Rural-dwelling older adults with cancer have limited access to palliative care and face barriers in coordinating palliative care with cancer care. This study aimed to identify barriers and facilitators to care coordination in the palliative care referral and care delivery process for rural-dwelling older adults with cancer from the perspectives of palliative care and oncology healthcare professionals (HCPs).</div></div><div><h3>Materials and Methods</h3><div>We conducted focus groups and dyadic semi-structured interviews with palliative care and oncology HCPs. Participants were recruited from clinics within large academic health systems (<em>n</em> = 14) and rural non-affiliated practices (<em>n</em> = 11) in Colorado. We analyzed interviews guided by a reflexive thematic analysis approach.</div></div><div><h3>Results</h3><div>Five themes emerged; within each theme specific barriers and facilitators were identified: (1) Tension of different practice styles delays palliative care referral for rural older adults; (2) Limited capacity prevents early palliative care integration for older adults in rural areas; (3) Structured communication pathways can facilitate coordinated care for older rural adults; (4) Competing influences of rural cultural context on older adults' palliative and oncologic care coordination; and (5) Telehealth has “come a long way,” offering more opportunities for rural older adults to receive effective care coordination. Participants also shared insights on intervention strategies targeting barriers to coordinating palliative care with cancer care for rural-dwelling older adults with cancer.</div></div><div><h3>Discussion</h3><div>The identified barriers and facilitators suggest intervention targets to improve care coordination between palliative care and cancer care for rural-dwelling older adults at the health system, provider, and patient levels.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102301"},"PeriodicalIF":3.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and evaluation of a nurse-led geriatric oncology model of care for older adults with lung cancer","authors":"Shalini K. Vinod ,&nbsp;Nicole Knox ,&nbsp;Katie Knight ,&nbsp;Victoria Bray ,&nbsp;Angela Khoo ,&nbsp;Elise Tcharkhedian ,&nbsp;Josephine Campisi ,&nbsp;Polly Dufton ,&nbsp;Gemma McErlean ,&nbsp;Meera R. Agar ,&nbsp;Louise Hickman","doi":"10.1016/j.jgo.2025.102302","DOIUrl":"10.1016/j.jgo.2025.102302","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102302"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysing the use of unsupervised learning to identify symptom clusters in older adults receiving chemotherapy – Response","authors":"Erika Ramsdale,&nbsp;Supriya Mohile","doi":"10.1016/j.jgo.2025.102291","DOIUrl":"10.1016/j.jgo.2025.102291","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 7","pages":"Article 102291"},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}