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Prevalence of Malnutrition and Frailty in Elderly Cancer Patients and Resulting Impact on Primary Treatment Recommendations in Colorectal and Breast Cancer

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Journal of Nutritional Oncology 2020年第4期5卷 162-169页

作者： Vittoria Balzano Véronique Dardaine Giraud carine sauger Carole Lefebvre Patrick Heitzmann Thierry Lecomtef Étienne Dorvalg OncoCentre-Regional Cancerology Network 37000 ToursFrance Geriatric Oncology Coordination Unit Regional Cancerology NetworkToursFranceDepartment of Geriatrics37000 Tours University HospitalFrance Department of Gastroenterology and Digestive Oncology 37000 Tour University HospitalFrance

Objectives To estimate the prevalence of malnutrition in elderly cancer patients and its association with frailty and primary cancer treatment recommendations in patients with the two most prevalent cancers(colorectal cancer,CRC and breast cancer,BC)in the Centre-Val de Loire region of *** The entire cohort of 704 patients aged 75 years or older presenting with cancer who underwent comprehensive geriatric assessment(CGA)between 2014 and 2017 was *** status,frailty(defined by the Balducci classification system based on CGA parameters and comorbidity),and pathological criteria were analyzed in terms of the cancer treatment recommendations suggested by geriatricians both in the whole cohort and in those with CRC and *** In the whole group of 704 patients(84.3+/-4.8 years),the prevalence of malnutrition was 62.9%,and was higher in CRC than in BC patients(71.1%vs 55.4%,P<0.01).In a multivariate analysis,malnutrition and frailty(as determined by the Balducci classification system)were independently related in CRC patients(OR:7.28,95%CI,1.58~34.03;P=0.012)and were unrelated to metastasis[odds ratio(OR):1.34,95%CI,0.56~3.18;P=0.5].By contrast,malnutrition in BC patients was related exclusively to the extent of metastasis(OR:3.52,95%CI,1.50~8.24;P=0.002).It was also demonstrated that geriatricians had a greater tendency to suggest only palliative care to CRC patients presenting with malnutrition(15.4%vs 2.7%,P=0.006)than to BC patients(9.8%vs 5.4%,NS).Conclusion Malnutrition in elderly cancer patients is prevalent,especially in those with colorectal cancer,where malnutrition is frailty-related and may strongly impact on cancer treatment strategies.

关键词： Elderly adult Geriatric oncology Malnutrition Geriatric assessment Treatment decision

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