Prostate cancer of elderly patients: Place and role of geriatric assessment

• Published in: Progrès en urologie (Paris) Vol. 26; no. 9; p. 524
• Main Authors: Méry, B, Vallard, A, Espenel, S, Badie, N, Thiermant, M, Lambert, V, Soulier, V, Piqueres, S, Del Santo, K, Ben Mrad, M, Wang, G, Diao, P, Langrand-Escure, J, Rivoirard, R, Guy, J-B, Guillot, A, Chanelière, A-F, Gonthier, R, Achour, E, Fournel, P, Magné, N
• Format: Journal Article
• Language: French
• Published: France 01-09-2016
• Subjects: Adenocarcinoma - therapy; Aged; Aged, 80 and over; Clinical Decision-Making; Geriatric Assessment - statistics & numerical data; Humans; Male; Prostatic Neoplasms - therapy; Retrospective Studies; Décision thérapeutique; Évaluation gériatrique; Geriatric assessment; Therapeutic decision; Elderly; Prostate cancer; Cancer de prostate; Patients âgés
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2016.07.002

The aim of this study was to appreciate the place and role of geriatric assessment in elderly patients with prostate cancer.
We performed a retrospective analysis of prostate cancer patients who underwent geriatric assessment during the therapeutic management from 2008 to 2014. Patient, tumor, treatment characteristics and their associated toxicity as well as the parameters of geriatric assessment were studied. The occurrence of geriatric assessment within the 3 months preceding a therapeutic decision was reviewed.
Data of seventy-four patients were analyzed with a median follow-up of 15.6 years. The average age at diagnosis was 74.3 and 80.6 at the geriatric assessment. At the time of the geriatric assessment 64 patients had metastatic disease, 39 were in poor condition more than 50% of patients had walking ability disorders. Thirteen patients underwent radical surgery, 28 received radiotherapy, 30 patients had chemotherapy and hormonotherapy was prescribed for 72 patients. The geriatric assessment, requested on average 15 years after diagnosis, was not carried out within the 3 months preceding treatment decision for 55 patients.
The recourse to geriatric assessment is predominantly used to endorse a decision of supportive care for elderly patients with prostate cancer. An early intervention by a geriatrician consultant for the initial management and then at each therapeutic event is a sine qua non condition for efficient personalized therapeutic management suitable to every patient according to physiological age.
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