Journal Of Geriatric Oncology[JOURNAL]
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200 papers
A scoping review of exercise oncology trials to inform best practice recommendations for exercise in older adults (65+ years) living with and beyond cancer.
Winters-Stone K, Crisafio M, Chalmers C … +3 more , Meyers G, Eckstrom E, Campbell KL
J Geriatr Oncol · 2025 Sep · PMID 40784303 · Full text
INTRODUCTION: We conducted a scoping review of published controlled exercise oncology trials to inform the development of best practice guidelines for delivering exercise to older cancer survivors. MATERIALS AND METHODS:...
INTRODUCTION: We conducted a scoping review of published controlled exercise oncology trials to inform the development of best practice guidelines for delivering exercise to older cancer survivors. MATERIALS AND METHODS: Eligible articles reported on controlled trials that allocated people ≥65 years old at enrollment and a history of cancer to ≥1 arm of structured exercise training lasting ≥4 weeks that was aimed to improve a health-related outcome. We extracted and summarized data on trial design, basic characteristics, trial outcomes, eligibility criteria, pre-exercise medical clearance, intervention characteristics, feasibility (accrual, retention, adherence, compliance), safety and tolerance. RESULTS: Out of 1790 articles identified, 1784 were excluded, yielding six eligible studies. Three trials tested a combined aerobic + resistance training program, one trial tested aerobic exercise only, one trial included resistance training only, and one trial compared an arm of resistance training to an arm of aerobic training. Main health-related outcomes were aerobic capacity (n = 1) and physical function (n = 5). Four out of six studies required medical clearance prior to participation and several studies excluded physical (n = 3) and/or cognitive limitations (n = 3). Trial accrual ranged from 21%-37%, adherence ranged from 48%-84%, and retention ranged from 61%-77%. Compliance with exercise training was rarely tracked or reported. One serious adverse event (syncope leading to hospitalization) possibly attributed to exercise was reported across all six trials. DISCUSSION: There are very few studies available to inform evidence-based exercise guidelines for older adult cancer survivors. In turn, consensus-based guidelines could provide recommendations so that older cancer survivors receive appropriate exercise guidance.
Prospective comparison between geriatric assessment and clinical evaluation in 200 newly diagnosed older adults with multiple myeloma.
Raddoux J, Kenis C, Vanhellemont A … +19 more , Meers S, Mineur P, Vekemans MC, Wu KL, Caers J, Van Eygen K, Kentos A, Depaus J, Put N, Van De Velde A, Claes G, Vlummens P, Maertens V, Meuleman N, Broek IV, Vaes M, Fostier K, Demuynck H, Delforge M
J Geriatr Oncol · 2025 Sep · PMID 40784302 · Publisher ↗
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Objectively measured physical function predicts mortality in older adults with acute myeloid leukemia treated by lower-intensity therapy: A prospective cohort study.
Kwag D, Cho BS, Park S … +1 more , Kim HJ
J Geriatr Oncol · 2025 Nov · PMID 40784042 · Publisher ↗
INTRODUCTION: In older adults with acute myeloid leukemia (AML) treated with intensive chemotherapy, the Short Physical Performance Battery (SPPB) and the short form of the Geriatric Depression Scale (SGDS-K) predict sur...
INTRODUCTION: In older adults with acute myeloid leukemia (AML) treated with intensive chemotherapy, the Short Physical Performance Battery (SPPB) and the short form of the Geriatric Depression Scale (SGDS-K) predict survival outcomes. However, their role in lower-intensity therapy remains unclear. We evaluated their prognostic role in older adults with AML treated with hypomethylating agents (HMA) with or without venetoclax (VEN). MATERIALS AND METHODS: In this single-center, prospective cohort study, patients with AML aged ≥60 years receiving HMA or HMA/VEN therapy were included. SPPB and SGDS-K scores were assessed before treatment, and their associations with overall survival (OS), other outcomes, and prognostic utility were analyzed. RESULTS: From November 2016 to June 2023, 124 (HMA: N = 52, HMA/VEN: N = 82) patients were enrolled. In the HMA group, there were 32 males and 20 females, while in the HMA/VEN group, there were 45 males and 37 females. The median follow-up duration was 62.1 months for the HMA group and 22.4 months for the HMA/VEN group. Impaired physical function (SPPB <10) was significantly associated with worse OS in patients receiving HMA/VEN (median 5.4 months [2.5-9.4] vs. 16.4 months [8.7-not reached], p = 0.004), but not in HMA-treated patients (median 7.8 months [3.3-17.7] vs. 8.6 months [2.4-22.8], p = 0.92). The association between impaired SPPB and OS in the HMA/VEN group remained statistically significant after adjusting for age and performance status in multivariable analysis. Impairment on the SGDS-K showed no association with OS in either group. In the HMA/VEN group, the addition of SPPB to the existing treatment-related mortality score model improved the prediction of early death, increasing the area under the receiver operating characteristic curve (AUC) from 0.659 to 0.804 (p = 0.02). Incorporation of SPPB into the Wheatley index also improved the AUC from 0.685 to 0.783, though it did not reach statistical significance (p = 0.06). DISCUSSION: This study highlights the prognostic role of objectively measured physical function on survival in older adults with AML treated with HMA/VEN therapy. Further research for independent verification of our findings is warranted, and incorporating objectively measured physical function into treatment decision-making could be considered. TRIAL REGISTRATION: This study is registered in the Clinical Research Information Service, CRIS, #KCT0002172, and #KCT0002261.
Personalized palliative care for older adults with cancer: A call for action on oncogeriatric palliative care.
Liposits G, Baxter MA, Brown-Kerr A … +1 more , O'Hanlon S
J Geriatr Oncol · 2025 Nov · PMID 40784041 · Publisher ↗
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What's on your mind? A qualitative analysis of concerns and self-management strategies among older adults with advanced cancer.
Booth G, Rahman M, Rosenzweig M … +2 more , Thomas TH, Schenker Y
J Geriatr Oncol · 2025 Sep · PMID 40782786 · Full text
INTRODUCTION: Older adults with cancer are living longer, but their unique concerns and approaches to self-management are not well understood. Self-management strategies (SMS), historically studied in other chronic disea...
INTRODUCTION: Older adults with cancer are living longer, but their unique concerns and approaches to self-management are not well understood. Self-management strategies (SMS), historically studied in other chronic diseases, are a promising approach for empowering older patients with cancer and reducing their symptom burden. Self-management strategies are behaviors aimed at coping with the physical sequelae of and psychosocial adjustment to life-limiting disease. We sought to characterize the concerns and self-management strategies of older patients with advanced cancer. MATERIALS AND METHODS: This was a secondary analysis of N = 179 initial visits conducted by oncology nurses with older adults (age ≥ 60) with advanced solid tumors as part of a primary palliative care trial. All visits were audio-recorded and transcribed. The team conducted a mixed inductive and deductive content analysis informed by the qualitative description framework. All transcripts were dual coded, with disagreements resolved by consensus. RESULTS: Patients were a mean age of 72±8 years and 51% (92/179) were female. Almost all (99%) patients expressed at least one concern and patients expressed a median of five concerns (range: 1-12), most commonly in the domains of physical (97%), emotional (60%), and functional (59%) well-being. Nearly all patients, 99% (177/179), were using or planning to use a self-management strategy and patients endorsed a median of five self-management strategies (range: 1-13), most commonly related to the domains of physical (82%), emotional (75%), and social (67%) well-being. DISCUSSION: Older adults express multiple concerns during primary palliative care visits and they are using a variety of self-management strategies to cope with their advanced cancer. Self-management strategies could be a useful tool for future supportive oncology interventions. TRIAL REGISTRATION: Originally registered with ClinicalTrials.gov on March 7th, 2016, ID# NCT02712229.
Optimizing care of older patients with cancer in India: Comparative study of risk prediction of three assessment tools.
Soni N, Banerjee J, Singh V … +3 more , Kumar L, Chakrawarty A, Dey AB
J Geriatr Oncol · 2025 Sep · PMID 40774232 · Publisher ↗
INTRODUCTION: Geriatric assessment is recommended for all older patients with cancer planned for treatment, but time and expertise required limit its use in routine oncology clinics. Screening tools help identify patient...
INTRODUCTION: Geriatric assessment is recommended for all older patients with cancer planned for treatment, but time and expertise required limit its use in routine oncology clinics. Screening tools help identify patients requiring complete geriatric assessment and also predict adverse outcomes. Our study aims to compare a culturally appropriate tool developed in India: SCreening for Older PErson with Cancer (SCOPE-C), Version 1, which helps triaging patients for treatment with other frequently used screening tools. MATERIALS AND METHODS: This single centre study was conducted in treatment-naïve older patients with cancer (aged ≥60 years) at a tertiary care hospital in North India from November 2019 to May 2022. Frequently used screening tools like the Geriatric 8(G-8) and Vulnerable Elders Survey (VES-13), and SCOPE-C were administered on older patients with cancer. Agreement between the scales was analyzed using Cohen's Kappa statistics and mortality risk prediction using logistic regression analysis. Cut offs implying impaired performance for each scale were: G8 ≤ 14, VES 13 ≥ 3, and SCOPE C < 64. Further, G8- cutoff of <12 previously proposed for the Indian population was also explored. RESULTS: Maximum agreement was observed between VES-13 and G-8 (73.13% [kappa = 0.081]), while SCOPE-C and VES-13 demonstrated a moderate level of concordance (62.19% [kappa = 0.321]). Agreement between SCOPE-C and G-8 was lower (43.28% [kappa = 0.056]). Propensity score matched (PSM) analysis revealed that an unfavorable score on SCOPE-C was significantly associated with higher mortality ratio (OR: 2.07 [95% CI: 1.07-4.03]), while VES-13 (OR: 1.31 [95% CI:0.57-3.04]),G8 cut off ≤14(OR: 0.78 [95% CI: 0.20-3.06]) and G8 cut off <12 (OR:1.49 [95%CI:0.62-3.63]) had no statistically significant association with mortality. DISCUSSION: SCOPE-C, Version 1 is a validated tool for the Indian population that considers the low literacy rate and socio-cultural milieu of the country. Though perceptible agreement was not seen between the scales, SCOPE-C had better risk predictive potential for mortality. Hence, we recommend using SCOPE-C for prognostication and decision making in resource constrained settings like India and other low- and middle-income countries with similar background.
Need and uptake of geriatric assessment-guided interventions in older Indian patients with cancer: A cross-sectional analytical study.
Noronha V, Pillai A, Mittal K … +20 more , Shetake A, Ramaswamy A, Rao A, Kumar A, Pant B, Singh A, Gosavi G, Dhekale R, Parab N, Tripathi V, Satamkar S, Mahajan S, Daptardar A, Ansari N, Vagal M, Sonkusare L, Deodhar J, Mahajan P, Gota V, Prabhash K
J Geriatr Oncol · 2025 Sep · PMID 40769074 · Publisher ↗
INTRODUCTION: Studies on the requirement and utilization of geriatric assessment (GA)-guided interventions are scarce, especially from low- and middle-income countries. We aimed to evaluate the number of referrals genera...
INTRODUCTION: Studies on the requirement and utilization of geriatric assessment (GA)-guided interventions are scarce, especially from low- and middle-income countries. We aimed to evaluate the number of referrals generated following the GA, uptake of GA-guided referrals for interventions in older patients with cancer, and factors influencing patient compliance. MATERIALS AND METHODS: This was a cross-sectional analytical study conducted in the geriatric oncology clinic of the Department of Medical Oncology at the Tata Memorial Hospital in Mumbai, India between June 2018 and July 2023. Participants underwent GA before starting systemic cancer-directed therapy, with referrals to various healthcare professionals based on vulnerabilities identified through the GA. Baseline patient-, tumor-, and GA-related data were collected, along with data on GA-guided referrals made and compliance to these referrals. Statistical analysis included regression models to identify factors associated with low compliance with GA-guided referrals focusing on demographic and clinical variables, and vulnerabilities in the GA. RESULTS: We enrolled 2544 older patients with cancer who had undergone a GA during the timeframe of the study. There were 2353 (92.5%) patients who were referred to at least one specialist after their GA, and 1750 (74.4%) patients attended at least one referral. The median number of referrals attended per patient was 50% (IQR, 0-75). Overall, only 2954 (44.8%) of the total 6594 GA-guided referrals made were attended collectively by the entire cohort of patients. The highest referral uptake was for dieticians (73.7%), and the lowest for general physicians (19.8%). Referral uptake for other interventions was 44.8% for physiotherapists, 30.3% for occupational therapists, and 27% for psychologists/psycho-oncologists. Factors associated with lower uptake of referrals were fatigue (OR = 1.49 [95% CI, 1.23-1.81]), depression (OR = 1.31 [95% CI, 1.07-1.59]), comorbidities (OR = 1.24 [95% CI, 1.03-1.49]), and palliative-intent therapy (OR = 1.57 [95% CI, 1.3-1.9]), while poor nutrition was associated with greater uptake of referrals (OR = 0.42 [95% CI, 0.32-0.55]). DISCUSSION: There is a substantial gap between the need for and the uptake of GA-guided interventions among older Indian patients with cancer. Focused efforts need to be made to bridge this gap to realize the benefits of the GA and optimize oncologic outcomes in older patients with cancer.
Geriatric assessment among vulnerable older adults undergoing stereotactic body radiotherapy for early-stage non-small cell lung cancer.
Thompson LL, Lipson SM, Yoon J … +12 more , Florissi C, Gregg AT, Amin PM, Shah S, Anabaraonye N, Jiang S, Baxter E, Saraf A, Fitzgerald K, Kann B, Kozono D, Mak RH
J Geriatr Oncol · 2025 Sep · PMID 40769073 · Publisher ↗
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Geriatric oncology in the Instagram era: A pilot randomised controlled trial of adjunct PhotoVoice versus usual care to enable cancer supportive care.
Steer CB, Rasekaba TM, Jayasuriya D … +5 more , Kapur M, Young K, Webb N, Owen K, Blackberry I
J Geriatr Oncol · 2025 Sep · PMID 40769072 · Publisher ↗
INTRODUCTION: PhotoVoice is a research methodology that facilitates an insight and dialogue into a person's identity, goals, and life using photographs. It is widely used in social sciences and healthcare, including canc...
INTRODUCTION: PhotoVoice is a research methodology that facilitates an insight and dialogue into a person's identity, goals, and life using photographs. It is widely used in social sciences and healthcare, including cancer, but has not been explored in geriatric oncology. We examined the feasibility and acceptability of implementing PhotoVoice in older adults at a regional cancer centre in Australia. MATERIALS AND METHODS: We conducted a pilot feasibility randomised controlled trial from 1 April to 30 August 2021. Inclusion criteria were age ≥ 70, a cancer diagnosis, newly referred to a regional cancer centre, Geriatric-8 score ≤ 14, and informed consent. Patient participants were randomised to PhotoVoice with enhanced supportive care (ESC) or ESC alone. Feasibility of PhotoVoice was defined by patient engagement (submission of four photographs, completion of interviews) and logistical integration into the multidisciplinary team (MDT) process. Acceptability was assessed through inductive thematic analysis of patient interviews and MDT member survey. Summary reports for patients in the PhotoVoice group were discussed at geriatric oncology MDT meetings. Treatment intent was a proxy measure of care decisions. Thematic analysis of interview transcripts was guided by Bronfenbrenner's socioecological framework to understand PhotoVoice with respect to healthcare-seeking behaviours. MDT members completed a feasibility, acceptability, and utility survey on PhotoVoice. RESULTS: Eighteen patients (n = 9 per arm) participated, mean age 79.3 (SD 5.6) years, and six were female. Four of seven MDT members completed the survey. As indicators of feasibility, four patient participants provided four photographs each, four provided more, and one provided two. PhotoVoice complemented ESC but was resource-intensive and time-consuming. Practical considerations for implementation in a busy cancer centre include reducing the number of photographs, streamlining time, and assigning a facilitator for interviews. Acceptability was supported by positive patient reflections and survey responses from MDT members, who valued PhotoVoice's holistic approach but noted timing and efficiency challenges. Patient summary reports were praised for offering richer patient insight, supporting the intervention's relevance and perceived utility. DISCUSSION: PhotoVoice to enhance supportive care in real-world geriatric oncology is feasible and acceptable. Patients and MDTs reported its benefits to enhance patient-centred care. Future research should mitigate the practical constraints of integrating PhotoVoice in practice and optimize effective implementation.
Mediating effects of social and clinical factors on racial disparities in cardiovascular outcomes following anthracycline therapy in older women with breast cancer.
Le N, Avanceña ALV, Liu Y … +2 more , Shen C, Park C
J Geriatr Oncol · 2025 Sep · PMID 40769071 · Publisher ↗
INTRODUCTION: Racial disparities in cardiovascular (CV) outcomes among breast cancer (BC) survivors are well-documented. However, whether such disparities persist following anthracycline therapy, a common cardiotoxic tre...
INTRODUCTION: Racial disparities in cardiovascular (CV) outcomes among breast cancer (BC) survivors are well-documented. However, whether such disparities persist following anthracycline therapy, a common cardiotoxic treatment, remains unclear. We aimed to quantify racial disparities in the incidence of major adverse cardiac events (MACE) and examine the role of the Social Vulnerability Index (SVI) in mediating these disparities. MATERIALS AND METHODS: We conducted a retrospective cohort study using the 2007-2019 SEER-Medicare database. We included females aged ≥66 years with a new primary diagnosis of BC who received anthracyclines within one year after diagnosis. The index date was the initiation date of anthracyclines. The study exposure was race (Black vs. White), a socially constructed variable reflecting structural and institutional racism and encompassing multiple levels of health determinants. The primary outcome was the 10-year incidence of MACE. Associations between race and MACE incidence were evaluated using weighted proportional hazards models. Adjusted risk differences (aRD) were calculated as the difference in predicted 10-year risk-free probabilities between groups, based on the final adjusted models from the index date. Mediation analysis determined the contributions of SVI (county-level and theme-specific variables), BC-related characteristics, and clinical factors. RESULTS: Among 5571 patients (22,154 person-years) who initiated anthracycline therapy, 2128 MACE events occurred. Black patients had a higher hazard of MACE (adjusted HR 1.2; 95% CI: 1.02 to 1.33), with a 10-year aRD of 2.3% (95% CI: 0.6% to 9.7%) compared to White patients. After adjusting for right-censoring, aHR was 1.3 (95% CI: 1.1 to 1.4) with a corresponding aRD of 7.8% (95% CI: 2.9% to 12.6%). Mediation analysis showed that the total percentage of mediation was 60.7 % (95% CI: 41.3% to 94.9%), primarily driven by clinical factors, which mediated 39.6% (95% CI: 25.7% to 64.3%). Hypertension, diabetes, anemia, obesity, and calcium-channel blocker use contributed considerably to the mediation. DISCUSSION: MACE incidence was significantly higher in older Black patients with BC after initiating anthracycline therapy compared with their White counterparts. Clinical factors considerably mediated this racial disparity. Early interventions, enhanced cardiac surveillance, and targeted prevention strategies may help reduce inequities in CV outcomes among older women with BC receiving anthracycline therapy.
Palliative Prognostic Index as a hospice care indicator for hematologic malignancy.
Chang YS, Huang YM, Wu TH … +5 more , Lai CH, Wu CC, Lee YC, Lee AL, Yeh KY
J Geriatr Oncol · 2025 Sep · PMID 40763627 · Publisher ↗
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Translation and psychometric validation of the Chinese version of the self-administered Geriatric-8 (S-G8) questionnaire for older patients with cancer.
Tan X, Mao P, Yu H … +11 more , Tang L, Alibhai SMH, Wu D, Zhang Y, Tian X, Zhou X, Dai Y, Liao J, Cui L, Shi Q, Li X
J Geriatr Oncol · 2025 Sep · PMID 40706252 · Publisher ↗
INTRODUCTION: We aimed to translate and cross-culturally validate the Self-administered Geriatric-8 (S-G8) into Chinese and investigate its psychometric properties in older Chinese patients with cancer. MATERIALS AND MET...
INTRODUCTION: We aimed to translate and cross-culturally validate the Self-administered Geriatric-8 (S-G8) into Chinese and investigate its psychometric properties in older Chinese patients with cancer. MATERIALS AND METHODS: This multi-center cross-sectional study was conducted at four hospitals. Participants were eligible if they were at least 60 years old and diagnosed with cancer. The translation process included seven steps: obtaining authorization, forward translation, reconciliation, backward translation, expert review, cognitive debriefing, and finalization. The final iteration of the S-G8 was evaluated along with the original Geriatric-8 (G8) in a linguistic validation study (N = 207) by calculating the psychometric properties including criterion validity, internal consistency, test-retest reliability, and known-groups validity. Known-groups validation was assessed to quantify the differences between Eastern Cooperative Oncology Group (<2 vs. ≥2), and patient purpose within treatment (palliative vs. others). RESULTS: We obtained permission to perform the S-G8 translation work on December 5, 2023. It took four weeks to complete the first five translation steps. Among the two-round cognitive debriefing, 12 items received revised comments from patient interviews. A strong correlation was found between G8 and S-G8 scores (r = 0.84, p < 0.001). Internal consistency was acceptable at 0.60, and the intraclass correlation coefficient was 0.82. The frequency of abnormality (<14 scores) for G8 and S-G8 was 52.9% and 56.8%, respectively. DISCUSSION: The Chinese version of the S-G8 questionnaire has been validated according to standard procedures. Consequently, it is deemed suitable as a geriatric screening tool for older adults with cancer in China.
Predictive value of G8 screening tool for ambulation failure and severe complications in the perioperative period: Results from a large single-center cohort study.
Imasato N, Yajima S, Ogasawara RA … +7 more , Kanagawa T, Inoue M, Hirose K, Sekiya K, Kataoka M, Nakanishi Y, Masuda H
J Geriatr Oncol · 2025 Sep · PMID 40700955 · Publisher ↗
INTRODUCTION: Older patients undergoing major urological cancer surgery are at increased risk of postoperative functional decline and complications, including ambulation failure, which can delay recovery, prolong hospita...
INTRODUCTION: Older patients undergoing major urological cancer surgery are at increased risk of postoperative functional decline and complications, including ambulation failure, which can delay recovery, prolong hospitalization, and reduce independence. Although perioperative rehabilitation may improve outcomes, identifying patients who would benefit the most remains challenging. The Geriatric-8 (G8) screening tool is a simplified frailty assessment, but its predictive value for postoperative ambulation failure in this population has not been fully investigated. This study aimed to evaluate whether the G8 score can predict postoperative ambulation failure and high-grade complications in older adults undergoing major urological cancer surgery. MATERIALS AND METHODS: This retrospective study analyzed 1754 patients who underwent major urological cancer surgery (radical cystectomy, radical prostatectomy, radical nephrectomy, partial nephrectomy, and radical nephroureterectomy) at a single tertiary center between January 2020 and December 2024. Preoperative G8 assessments were performed, and patients were classified as normal (G8 > 14) or abnormal (G8 ≤ 14). The primary endpoint was postoperative ambulation failure, and the secondary endpoint was high-grade postoperative complications (Clavien-Dindo classification grade ≥ 3). Logistic regression models were conducted to identify predictors of these outcomes, and the discriminative ability of the G8 score was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: Of the 1754 included patients (median age 73 years [IQR: 69-77]; 89.3% male), 784 (44.7%) had an abnormal G8 score. Postoperative ambulation failure was significantly more common in the abnormal G8 group (9.2% vs. 1.1%, P < 0.001). In multivariable analysis, an abnormal G8 score (odds ratio [OR] 5.75, 95% confidence interval [CI] 2.99-11.1), American Society of Anesthesiologists physical status ≥3 (OR 4.90, 95% CI 2.42-9.93), and radical cystectomy (OR 7.08, 95% CI 3.68-13.6) were independently associated with postoperative ambulation failure. Abnormal G8 scores were independently associated with high-grade postoperative complications (OR 2.00, 95% CI 1.01-3.96). ROC analysis demonstrated good discriminative ability of the G8 score for predicting ambulation failure (area under the curve 0.787, 95% CI 0.750-0.823). DISCUSSION: An abnormal preoperative G8 score was independently associated with postoperative ambulation failure and high-grade complications in patients who underwent major urological cancer surgery. Incorporating the G8 screening tool into preoperative assessments may help identify high-risk patients who could benefit from early rehabilitation and tailored perioperative management. Future prospective studies are warranted to validate these findings and evaluate the impact of G8-based interventions on postoperative recovery.
Effect of geriatric interventions on postoperative outcomes in frail older patients undergoing elective gastrectomy for gastric cancer.
Chang CY, Lu CH, Hung CY … +6 more , Liu KH, Hsu JT, Tsai CY, Yeh TS, Hung YS, Chou WC
J Geriatr Oncol · 2025 Sep · PMID 40694948 · Publisher ↗
INTRODUCTION: Postoperative complications are common after gastrectomy for gastric cancer, particularly in older patients with increased frailty. This study evaluates the impact of targeted geriatric interventions on pos...
INTRODUCTION: Postoperative complications are common after gastrectomy for gastric cancer, particularly in older patients with increased frailty. This study evaluates the impact of targeted geriatric interventions on postoperative outcomes in frail older patients undergoing gastrectomy. MATERIALS AND METHODS: A total of 120 frail patients aged 65 years and older were enrolled in a before-and-after study design. Participants were divided into a standard care group (n = 52) and an intervention group (n = 68) of comparable characteristics. All participants underwent a comprehensive geriatric assessment (CGA) before surgery to identify frailty. The intervention group received targeted geriatric interventions consisting of nutritional support, comorbidity management, and physical therapy in addition to standard care. Postoperative outcomes, including length of hospital stay (LOS), intensive care unit (ICU) admission rates, and postoperative complications were compared between the groups. RESULTS: The intervention group demonstrated significantly lower rates of ICU admissions (11.8% vs. 34.6%, p = 0.003), emergency room visits (2.1% vs. 42.3%, p = 0.02), and 30-day readmissions (14.7% vs. 32.7%, p = 0.02) compared to the standard care group. The median LOS was comparable between the groups (18 days vs. 19 days, p = 0.73). While overall complication rates (10.3% vs. 21.2%, p = 0.10) and 30-, 90-, and 180-day postoperative mortality rates were numerically lower in the intervention group, these differences were not statistically significant. DISCUSSION: Targeted geriatric interventions during the perioperative period significantly reduced ICU admissions, emergency room visits, and hospital readmissions among frail older patients undergoing gastrectomy for gastric cancer. These findings support the routine integration of geriatric care strategies to improve postoperative recovery and reduce adverse outcomes in older surgical patients.
Well-being of cancer survivors with exceptional longevity: A cross-sectional and prospective cohort study of centenarians and very old adults.
Shikimoto R, Gondo Y, Yasumoto S … +6 more , Abe Y, Yagasaki K, Yoshimura K, Mimura M, Hirose N, Arai Y
J Geriatr Oncol · 2025 Sep · PMID 40694947 · Publisher ↗
INTRODUCTION: Studies on well-being and life expectancy of cancer survivors with exceptional longevity are scarce. We explored the relationship between cancer history and well-being and blood biomarkers in centenarians a...
INTRODUCTION: Studies on well-being and life expectancy of cancer survivors with exceptional longevity are scarce. We explored the relationship between cancer history and well-being and blood biomarkers in centenarians and very old adults. We also aimed to examine the life expectancy of cancer survivors. MATERIALS AND METHODS: Within three population-based cohorts in Japan, we recruited very old adults (85-94 years) and centenarians (100-115 years) between 2000 and 2020, and followed them up. Cancer survivors were defined as having been diagnosed with cancer regardless of whether they had been treated or not. Participants lacking history of cancer diagnosis or those who were not assessed using the Philadelphia Geriatric Center (PGC) Morale Scale were excluded. Participants' well-being was measured using the PGC Morale Scale, which included three subcategories: age attitude, social well-being, and psychological well-being. Multivariate LASSO (Least Absolute Shrinkage and Selection Operator) regression analysis and linear regression analysis were used to investigate whether having been diagnosed with cancer predicted the total PGC Morale Scale score, and multivariate Cox regression analysis was performed to assess life expectancy from the baseline survey. RESULTS: Among 1531 participants (very old, n = 532; centenarians, n = 999), 207 (13.5%) had been diagnosed with cancer. The association between cancer history and well-being differed significantly by age group. Very old individuals with a cancer history were not significantly associated with well-being scores. In contrast, centenarians with a cancer history had higher total well-being (B [95% CI] = 1.28 [0.08-2.49]) and showed a trend toward higher social well-being (B [95% CI] = 0.46 [-0.08-0.99]). No significant life expectancy differences were found between the very old and centenarian cancer survivors. DISCUSSION: The impact of a history of cancer on well-being differed between very old adults and centenarians. Centenarian cancer survivors showed greater well-being, particularly in social well-being. Moreover, the life expectancy of cancer survivors did not differ significantly from that of individuals without a cancer history.
Treatment-related cognitive changes in multiple myeloma: A systematic review and meta-analysis.
Patel S, Parrish C, Seymour F … +1 more , Burke M
J Geriatr Oncol · 2025 Sep · PMID 40684516 · Publisher ↗
INTRODUCTION: Multiple myeloma (MM) is an incurable blood cancer with improved survival rates due to advances in treatment, including stem cell transplantation, chemotherapy, and drug therapy. However, cognitive impact o...
INTRODUCTION: Multiple myeloma (MM) is an incurable blood cancer with improved survival rates due to advances in treatment, including stem cell transplantation, chemotherapy, and drug therapy. However, cognitive impact of therapies remains unclear. This study aimed to systematically review cognition in patients with MM across treatment pathways and estimate overall effects to determine whether patients experienced cognitive changes after treatment initiation. MATERIALS AND METHODS: A comprehensive search was conducted in PsycINFO, MEDLINE, Embase, and Google Scholar for full-text English articles from 2000 to 2024, aligned with the era of new treatment advances. The review included longitudinal studies and randomized controlled trials (RCTs) on cognition and quality of life in patients with MM treated via three common pathways. Measures included objective tools like the Montreal Cognitive Assessment (MoCA) and self-reported questionnaires like the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). Two reviewers independently extracted data and assessed study bias. The meta-analyses examined cognitive changes from baseline up to six months from the start of treatment. This duration was identified due to being an intensive phase in MM therapy. RESULTS: Eighteen studies (N = 5843) were reviewed, and eight (N = 3602) contributed to the meta-analysis. The risk of bias analysis revealed a potential self-selection bias in participant recruitment onto studies, meaning sample populations may not be representative of the MM community. The meta-analysis revealed a significant cognitive decline from baseline across all treatment during the first six months of treatment (standardized mean difference = 1.10, p = .02). DISCUSSION: Perceived cognitive decline is prevalent in patients with MM during active treatment (<6 months), but not during the maintenance phase of MM treatment (>6 months). However, findings predominantly rely on self-reported cognitive outcomes, rather than objective assessments, which may limit reliability. More RCTs are needed to investigate domain-specific cognitive impacts using standardized objective measures. In addition, comparisons of cognitive outcomes relative to age/education-matched healthy controls should be made to evaluate cancer-related cognitive impairment.
Longitudinal changes in cognition in older individuals receiving lymphoma-directed therapy: A pilot feasibility study.
Balitsky AK, Pond GR, Mian H … +5 more , Davies GA, Fraser G, Foley R, Sussman J, Kouroukis T
J Geriatr Oncol · 2025 Sep · PMID 40682962 · Publisher ↗
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Virtual reality-based cognitive assessment: An exploratory pilot study including patients with cancer-related cognitive impairment.
Cheng JJ, Davidovics H, Jackson NJ … +5 more , Wang R, Bakshian J, Sebti R, Waksman M, Naeim A
J Geriatr Oncol · 2025 Sep · PMID 40680691 · Publisher ↗
INTRODUCTION: Cancer-related cognitive impairment (CRCI), or "chemo brain," can adversely affect quality of life and potentially survival for patients with cancer. CRCI can especially impact older adults with cancer. Cog...
INTRODUCTION: Cancer-related cognitive impairment (CRCI), or "chemo brain," can adversely affect quality of life and potentially survival for patients with cancer. CRCI can especially impact older adults with cancer. Cognitive assessment remains challenging in a busy oncology practice, and virtual reality (VR) based assessment is an emerging option. VR-based assessment utilizes an immersive, multisensory virtual reality environment to evaluate cognitive function. One such platform includes the Virtuleap Enhance application. Our goal was to compare Virtuleap Enhance to standard cognitive assessments. MATERIALS AND METHODS: This was a single-center pilot study that included healthy participants and those with CRCI. Standard assessments included Montreal Cognitive Assessment (MOCA), Trail Making Test (TMT), Word Recall, and Stroop tasks. Subjects were assessed for three sessions, at least one month apart. Virtuleap Enhance applications included React (task switching, response inhibition), Memory Wall (short-term memory), Magic Deck (long-term memory), and Odd Egg (deductive reasoning). Statistical analysis included multiple imputed linear mixed effects regression model with inverse probability weighting. Significance was defined as p < 0.05. RESULTS: The overall cohort included 54 participants, including 35% experiencing CRCI; the mean age was 65 years. Those with CRCI had higher depression, stress, and anxiety scores with lower MOCA scores compared to healthy controls. Among the CRCI group, there were reliable correlations between the React task and the MOCA and Stroop tests while other VR tasks (Odd Egg, Memory) showed no reliable association. There was significant change over time for the React and Odd Egg tasks. DISCUSSION: VR showed reliable correlation with traditional cognitive assessments for some comparisons but not others. Some change over time was noted for certain VR tasks. This could be due to VR assessment measuring subtle changes in chemo brain that traditional testing may not necessarily capture. Future work based on lessons learned from this initial study may help clarify this possibility.
Symptoms associated with minimally invasive esophagectomy in older adults with esophageal cancer: Application of latent class analysis and network analysis.
He J, Lu X, Meng X … +2 more , Xia H, Li S
J Geriatr Oncol · 2025 Sep · PMID 40680690 · Publisher ↗
INTRODUCTION: Older adults with esophageal cancer often present with multiple coexisting symptoms after minimally invasive esophagectomy owing to factors such as surgical trauma. Significant heterogeneity exists in the s...
INTRODUCTION: Older adults with esophageal cancer often present with multiple coexisting symptoms after minimally invasive esophagectomy owing to factors such as surgical trauma. Significant heterogeneity exists in the symptom experiences of different patient groups, suggesting the need to provide a basis for precise clinical interventions by identifying the symptom characteristics and core symptoms of different categories. Studies using latent class analysis (LCA) combined with a symptom network approach to explore postoperative symptom characteristics in older adults with esophageal cancer are lacking. This investigation was designed to utilize LCA to recognize varied symptom categories among patients and to analyze the core symptom traits within each category. MATERIALS AND METHODS: Older adults one month post-minimally invasive esophagectomy who received treatment in the thoracic surgery departments of four tertiary-level hospitals in Hefei City, Anhui Province from August 2022 to February 2024 were selected by convenience sampling. A general information questionnaire and the Convalescence Symptom Assessment Scale for Oesophagectomy Patients were administered to collect data from the participants. LCA was performed to identify symptom categories. Category characteristics were determined by regression analysis and network analysis. RESULTS: Of the 450 patients, 27.3% (Class 1) were placed in the "high symptom burden group" and 72.7% (Class 2) were categorized into the "low symptom burden group". Patients who were married, had family monthly income less than ¥3000, had stage I/II esophageal cancer, and underwent cervical anastomosis were more likely to be in Class 2. Network analysis revealed that in Class 1, cough with phlegm (rs = 1.81) and sadness (rs = 1.71) served as core symptoms, while limited mobility (rs = 1.84) and worry (rs = 1.66) emerged as the core symptoms in Class 2. DISCUSSION: Patients exhibit heterogeneity in their symptom manifestations, with different categories having distinct symptom networks. This study identified two patient types based on symptom severity, providing valuable insights for personalized care, maximizing the effects of interventions, and reducing patients' symptom burden. In the future, large-scale, multi-center longitudinal studies are needed to validate and further explore the two distinct classes identified in this study.
Variation in bone health management in older women with breast cancer: A secondary analysis of the Age Gap study.
Theodoulou E, Martin C, Morgan J … +10 more , Turner O, Hartup S, Achuthan R, Azmy I, Henderson J, Reed M, Holen I, Brown J, Wyld L, Age Gap Trial Steering Group
J Geriatr Oncol · 2025 Sep · PMID 40680689 · Publisher ↗
INTRODUCTION: Physiological age-related bone loss is common, with 50% of women aged ≥80 having osteoporosis. Bone loss is exacerbated in women receiving aromatase inhibitors (AIs) for early breast cancer (EBC), increasin...
INTRODUCTION: Physiological age-related bone loss is common, with 50% of women aged ≥80 having osteoporosis. Bone loss is exacerbated in women receiving aromatase inhibitors (AIs) for early breast cancer (EBC), increasing fracture risk. This study explored the management of bone-health in older women (≥70 years) with EBC and factors influencing clinical decision-making. MATERIALS AND METHODS: This was a sub-study of a larger United Kingdom multicentre observational study into practice variation and outcomes in older women (≥70) with EBC (Age Gap study). Participants were aged ≥70 years with EBC; data were collected on health status, treatments, and outcomes. This sub-study focused on patients recruited at five hospitals, where more detailed data on bone health and management were collected for women with ER + ve (oestrogen receptor positive) cancers who received adjuvant or primary endocrine therapy treatment. We aimed to determine factors influencing treatment selection and outcomes in this age group. RESULTS: The main Age Gap study recruited between 2013 and 2018. In this sub-study, 565 patients had ER + ve cancers, of whom 529 (93.6%) received AIs and 26 (4.6%) tamoxifen. The median age of participants was 77 years (70-98 years). A baseline dual energy x-ray absorptiometry (DEXA) scan was performed in only 354/529 (67%) of the AI group. Bisphosphonates were prescribed for 226/529 (43%). Baseline DEXA scans were more likely to be requested if patients were fit for surgery and were < 80 years old. Of those scanned (n = 354), 148 (42%) were osteopenic and 64 (18%) osteoporotic. Bisphosphonate prescription was associated with younger age (<80 years old) (p = 0.02). From recruitment to 2022, fractures were diagnosed in 23% of participants (122/529), of whom only 38% (46/122) had received prior bisphosphonates. Frailty or prefrailty (Rockwood scale) were present in 94% (431/461), but there was no correlation between frailty and baseline hip (r = 0.0098) or spine (r = 0.00007) T-scores. Rates of DEXA scanning varied between centres from 36% to 76% (p < 0.001) for unknown reasons. DISCUSSION: Age and general health influenced bone-health management decision-making, but there was considerable variation between centres, highlighting the need for standardised bone-health care for older women with EBC.
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