Medline ® Abstract for Reference 16
of 'The approach to ovarian cancer in older women'
Development of a geriatric vulnerability score in elderly patients with advanced ovarian cancer treated with first-line carboplatin: a GINECO prospective trial.
Falandry C, Weber B, Savoye AM, Tinquaut F, Tredan O, Sevin E, Stefani L, Savinelli F, Atlassi M, Salvat J, Pujade-Lauraine E, Freyer G
Ann Oncol. 2013 Nov;24(11):2808-13. Epub 2013 Sep 22.
BACKGROUND: Two previous GINECO elderly specific studies in advanced ovarian cancer (AOC) patients highlighted the prognostic value of geriatric covariates for overall survival (OS).
PATIENTS AND METHODS: This open-label prospective trial was designed to identify the impact of geriatric covariates on OS in AOC patients≥70 years treated with first-line carboplatin.
RESULTS: Geriatric covariates of the 111 patients included median age 79 years (≥80 years: 41%); performance status (PS)≥2: 47%;≥3 major comorbidities: 24%;≥4 comedications: 68%; activities of daily living (ADL) score<6: 55%; instrumental activities of daily living (IADL) score<25: 69%; Hospital Anxiety and Depression Scale (HADS)>14: 37%. The median OS was 17.4 months. Overall, 74% of patients completed the six planned chemotherapy cycles. Grade 3-4 haematological toxic effects were frequent (50%) but manageable. Grade 3-4 non-haematological toxicities included fatigue (15%), anorexia (12%), infections (9%) and thrombosis (2%). A survival score = exp(0.327*GVS) was developed, where the geriatric vulnerability score (GVS) is the sum of the following (each assigned a value of one): albuminaemia<35 g/l; ADL score<6; IADL score<25; lymphopaenia<1 G/l; and HADS>14. With a cut-off≥3, GVS discriminated two groups with significantly different OS, treatment completion, severe adverse events and unplanned hospital admissions rates.
CONCLUSIONS: The GVS is a valuable tool for identifying vulnerable patients when treating an elderly AOC population.
Geriatrics and Oncology Unit, Centre Hospitalier Lyon Sud, UniversitéLyon 1, Pierre-Benite.