Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer

Fecha de publicación: 01/04/2021 Fecha Ahead of Print: 10/04/2021

Autores de IIS La Fe

Regina Gironés Sarrió

Autor

Participantes ajenos a IIS La Fe

Feliu, J
Pinto, A
Basterretxea, L
Lopez-San Vicente, B
Paredero, I
Llabres, E
Jimenez-Munarriz, B
Antonio-Rebollo, M
Losada, B
Espinosa, E
Custodio, AB
Munoz, MD
Diaz-Almiron, M
Gomez-Mediavilla, J
Torregrosa, MD
Soler, G
Cruz, P
Higuera, O
Gonzalez-Montalvo, JI
Molina-Garrido, MJ

Abstract

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.

Datos de la publicación

ISSN/ISSNe:: 2077-0383, 2077-0383
Tipo:: Article
Páginas:: -
DOI:: 10.3390/jcm10081615
Factor de Impacto:: 1,040 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Feliu, J:: Hosp Univ La Paz, Oncol Dept, IDIPAZ, Catedra UAM AMGEN,CIBERONC, Madrid 28046, Spain
Pinto, A:: Hosp Univ La Paz, Oncol Dept, IDIPAZ, Catedra UAM AMGEN,CIBERONC, Madrid 28046, Spain
Basterretxea, L:: Donostia Unibertsitate Ospitalea, Oncol Dept, OSI Donostialde, Donostia San Sebastian 20014, Gipuzkoa, Spain
Lopez-San Vicente, B:: OSI Bilbao, Oncol Dept, Bilbao 48013, Spain
Paredero, I:: Hosp Univ Dr Peset, Oncol Dept, Valencia 46017, Spain
Llabres, E:: Hosp Univ Insular Gran Canarias, Oncol Dept, Las Palmas Gran Canaria 35016, Spain
Jimenez-Munarriz, B:: Ctr Integral Oncol Clara Campal, Oncol Dept, Madrid 28050, Spain
Antonio-Rebollo, M:: IDIBELL, Inst Catala Oncol, Oncohematogeriatr Unit, Barcelona 08908, Spain
Losada, B:: Hosp Univ Fuenlabrada, Oncol Dept, Fuenlabrada 28942, Spain
Espinosa, E:: Hosp Univ La Paz, Oncol Dept, IDIPAZ, Catedra UAM AMGEN,CIBERONC, Madrid 28046, Spain
Girones, R:: Hosp Univ & Politecn La Fe, Oncol Dept, Valencia 46026, Spain
Custodio, AB:: Hosp Univ La Paz, Oncol Dept, IDIPAZ, Catedra UAM AMGEN,CIBERONC, Madrid 28046, Spain
Munoz, MD:: Hosp Virgen Luz, Oncol Dept, Cuenca 16002, Spain
Diaz-Almiron, M:: Univ Autonoma Madrid, Hosp La Paz, Biostat Dept, Madrid 28046, Spain
Gomez-Mediavilla, J:: Donostia Unibertsitate Ospitalea, Oncol Dept, OSI Donostialde, Donostia San Sebastian 20014, Gipuzkoa, Spain
Torregrosa, MD:: Hosp Univ Dr Peset, Oncol Dept, Valencia 46017, Spain
Soler, G:: IDIBELL, Inst Catala Oncol, Oncohematogeriatr Unit, Barcelona 08908, Spain
Cruz, P:: Hosp Univ La Paz, Oncol Dept, IDIPAZ, Catedra UAM AMGEN,CIBERONC, Madrid 28046, Spain
Higuera, O:: Hosp Univ La Paz, Oncol Dept, IDIPAZ, Catedra UAM AMGEN,CIBERONC, Madrid 28046, Spain
Gonzalez-Montalvo, JI:: Hosp Univ La Paz, Geriatr Dept, IDIPAZ, Madrid 28046, Spain
Molina-Garrido, MJ:: Hosp Virgen Luz, Oncol Dept, Cuenca 16002, Spain