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Giantin V, Falci C, De Luca E, Valentini E, Iasevoli M, Siviero P, Maggi S, Martella B, Crepaldi G, Monfardini S, Manzato E. Performance of the Multidimensional Geriatric Assessment and Multidimensional Prognostic Index in predicting negative outcomes in older adults with cancer. Eur J Cancer Care (Engl) 2016; 27. [PMID: 27726223 DOI: 10.1111/ecc.12585] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2016] [Indexed: 12/27/2022]
Abstract
The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores. SETTINGS Geriatric Clinic, Geriatric Surgery Clinic, Medical Oncology Unit, Padova Hospital, Italy. Using Cohen's Kappa coefficient, there was a poor concordance between the MPI and MGA. Severe MPI being associated with a higher mortality risk than Frail in the MGA. The ROC curves indicated that the MPI had a greater discriminatory power for 12-month mortality than the MGA. In our population of elderly cancer patients, the MPI performed better than the MGA in predicting mortality. Further evidence from larger prospective trials is needed to establish whether other geriatric scales, such as the GDS and CIRS-SI, could enhance the value of prognostic indexes applied to elderly cancer patients.
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Affiliation(s)
- V Giantin
- Department of Medical Sciences, Geriatric Clinic, University of Padova, Padova, Italy
| | - C Falci
- Medical Oncology Unit II, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - E De Luca
- Department of Medical Sciences, Geriatric Clinic, University of Padova, Padova, Italy
| | - E Valentini
- Department of Medical Sciences, Geriatric Clinic, University of Padova, Padova, Italy
| | - M Iasevoli
- Department of Medical Sciences, Geriatric Clinic, University of Padova, Padova, Italy
| | - P Siviero
- CNR, Aging Section, Institute of Neuroscience, Padova, Italy
| | - S Maggi
- CNR, Aging Section, Institute of Neuroscience, Padova, Italy
| | - B Martella
- Department of Surgical and Gastroenterological Sciences, Geriatric Surgery Clinic, University of Padova, Padova, Italy
| | - G Crepaldi
- CNR, Aging Section, Institute of Neuroscience, Padova, Italy
| | - S Monfardini
- Programma Oncologia Geriatrica, Istituto Palazzolo, Fondazione Don Gnocchi, Milano, Italy
| | - E Manzato
- Department of Medical Sciences, Geriatric Clinic, University of Padova, Padova, Italy
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Giantin V, Falci C, De Luca E, Valentini E, Lasevoli M, Siviero P, Maggi S, Martella B, Orrù G, Crepaldi G, Monfardini S, Terranova O, Manzato E. The Multidimensional Prognostic Index (MPI) predicts mortality in elderly cancer patients (ECP) better than the traditional Comprehensive Geriatric Assessment (CGA). Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Giantin V, Falci C, De Luca E, Valentini E, Iasevoli M, Siviero P, Maggi S, Martella B, Orrù G, Crepaldi G, Monfardini S, Terranova O, Manzato E. The Multidimensional Prognostic Index (MPI) predicts mortality in elderly cancer patients (ECP) better than the traditional Comprehensive Geriatric Assessment (CGA). Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Falci⁎ C, Giantin V, Valentini E, Lasevoli M, De Luca E, Siviero P, Maggi S, Martella B, Orrù G, Crepaldi G, Monfardini S, Terranova O, Manzato E. The multidimensional prognostic index (MPI), based on a comprehensive geriatric assessment (CGA), predicts mortality in elderly cancer patients (ECP). J Geriatr Oncol 2012. [DOI: 10.1016/j.jgo.2012.10.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bruttocao A, Terranova C, Martella B, Spirch S, Nistri R, Gruppo M, Mazzalai F, Lorenzetti R, Militello C. Site of ulcer lesions in diabetic foot of the elderly. BMC Geriatr 2010. [PMCID: PMC3290190 DOI: 10.1186/1471-2318-10-s1-a47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bruttocao A, Terranova C, Martella B, Spirch S, Nistri R, Gruppo M, Mazzalai F, Lorenzetti R, Militello C. Surgery of diabetic foot in the elderly: early Vs deferred treatment. BMC Geriatr 2010. [PMCID: PMC3290189 DOI: 10.1186/1471-2318-10-s1-a46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Spirch S, Tona F, Bruttocao A, Martella B, Militello C, Gruppo M, Mazzalai F, Lorenzetti R, Sirianni C, Terranova O. Pluriannual experience in stapled haemorrhoidopexy in the elderly. BMC Geriatr 2010. [PMCID: PMC3290225 DOI: 10.1186/1471-2318-10-s1-a79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bruttocao A, Terranova C, Martella B, Spirch S, Nistri R, Gruppo M, Mazzalai F, Lorenzetti R, Militello C. Rate of amputation and mortality in new-onset diabetic foot ulcers in the elderly. BMC Geriatr 2010. [PMCID: PMC3290191 DOI: 10.1186/1471-2318-10-s1-a48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Martella B, Militello C, Spirch S, Bruttocao A, Nistri R, De Rossi A, Barbon B, Terranova O. Palliative surgery for gastric cancer in elderly patients. Acta Biomed 2005; 76 Suppl 1:49-51. [PMID: 16450511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Poor survival rate of elderly patients affected by locally advanced or metastatic gastric cancer is related to primary tumour complications. Bleeding is the most important adverse event, other major complications are gastric outlet obstruction and nutritional deprivation. Rarely the patients will perforate the stomach cancer and there is a sudden end to their life; contamination of the ascites result in a rapid death. Thus, an aggressive approach toward palliation of this condition is resection: in this manner the expected survival is approximately one year. Derivation techniques or endoscopic treatments are applied in those patients whose operative risk is inacceptable; in these cases poor median survival is expected. The aim of this report in to refer about the experience in palliative surgery for gastric cancer in the Department of Geriatric Surgery of the University of Padua.
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Affiliation(s)
- B Martella
- Department of Geriatric Surgery, University of Padua, Padua, Italy
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De Santis L, Bruttocao A, Militello C, Martella B, Terranova O. [Septic shock: surgical and medical problems in the elderly]. Ann Ital Chir 2003; 74:261-4. [PMID: 14677279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The sepsis is a bacterial invasion of the organism producing many manifestations which are able to amplify themselves. In the United States of America there are 100,000 death per year and the incidence is among 300,000-500,000 cases. The major surgery in the elder (especially if it is in emergency) has a great percental of risk because the preoperative study isn't often complete. Fever, agitation, panting, bullation, abdominal splinting, enteroplegia, are signals of evolving inflammatory situation. Moreover there are disorders of biochemical values: leukocytosis, thrombocytopenia, increased levels of VES, PCR, amylase and biliribinaemia. The more common radiological examinations are the straight radiography of abdomen and horax, abdomen ultrasonography, CT or MRI. In the last years pro-calcitonin, interleukin-6 , C-reactive protein, and nitric oxide from endothelial and muscularis cells have been evaluated as prognostic factors in the septic shock.
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Affiliation(s)
- L De Santis
- Dipartimento di Scienze Chirurgiche e Gastroenterologiche Sezione di Clinica Chirurgica Geriatrica Azienda Ospedaliera, Università di Padova
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Bruttocao A, De Santis L, Militello C, Martella B, Terranova O. [Therapeutic strategy in neoplasia of the pancreas and ampulla]. Ann Ital Chir 2003; 74:269-74. [PMID: 14677281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The major symptoms of periampullary neoplasia are jaundice, lowering of weight, abdominal pain extending behind; diabetes, pancreatitis or exocrine pancreatic failure are uncommon. In the last years, surgery has been considered as the gold standard of the therapy because new technologies are able to reduce morbility and mortality. In the too advanced neoplasia, palliative surgical care permits better survival and quality of life. The duodenopancreatectomy today has a low perioperative mortality (0-3%) and an acceptable survival (15.25%). Good results were found for palliative surgery in unresectable neoplasms while in the inoperable patients we consider endoscopic and radiological treatments better than chemotherapy because they are able to correct the jaundice, improving quality of life (but not survival).
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Affiliation(s)
- A Bruttocao
- Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Sezione di Chirurgica Geriatrica Azienda Ospedaliera, Università di Padova
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Martella B, Nistri R, Spirch S, De Santis L, Militello C, Terranova O. [Stomach cancer in the elderly]. Chir Ital 1999; 49:47-9. [PMID: 10392184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Gastric cancer often affect very old patients even if it is not a typical disease of the elderly. The Authors report their experience on 108 patients (mean age of 77.8 years) affected by gastric cancer; early diagnosis and surgical technique are discussed.
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Affiliation(s)
- B Martella
- Clinica Chirurgica Geriatrica, Università degli Studi di Padova
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Spirch S, Martella B, Militello C, Nistri R, De Santis L, Ciardo L, Dalla Vecchia D, Perelda F, Reale F, Sarri C, Volpin E, Terranova O. [Surgery of inguinal and femoral hernia in the elderly]. Chir Ital 1999; 49:53-5. [PMID: 10392186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Old people are continuously increasing in frequency but age is not a significant factor to value the operative risk in hernia surgery. From June 1985 to December 1996, 189 patients, aged > 80-year, were submitted to hernia surgery. No complications were noted when elective surgery was performed. Emergent procedure was undertaken in 7% of the patients major perioperative complications and one death were registered in this group of patients. Mean hospital stay has decreased in the period of the study: was 2.2 days in the last two years. Local anesthesia permitted a day surgery procedure in 60% of cases.
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Affiliation(s)
- S Spirch
- Clinica Chirurgica Geriatrica, Università degli Studi di Padova
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Militello C, Volpin E, De Santis L, Martella B, Nistri R, Spirch S, Terranova O. [Complications of peptic ulcer disease in the elderly]. Chir Ital 1999; 49:37-41. [PMID: 10392182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Peptic disease is even more described in the elderly patients. Is it different from the young people peptic disease? Is it a specific syndrome? These questions are debated by the authors from their experience about in the old age surgery. In 1997, out of 569 oesophago-gastro-duodenoscopies positive for peptic disease, about 2/5 of the patients were older than 65-year with a high percentage of hypersecretive patients. Also the incidence of complications is similar in the aged and young patients, but their course is much more serious in the elderly. NSAID therapy was not always demonstrated as a determining factor of complications in the elderly. The ulcer perforation is the most serious complication; in the over-70 year aged persons a very severe course is often demonstrated. In conclusion in the elderly a specific diagnostic and therapeutic care is recommended to avoid the high incidence of deadly complications.
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Affiliation(s)
- C Militello
- Dipartimento di Scienze Chirurgiche e Gastroenterologiche P.G. Cévese, Università degli Studi di Padova
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De Santis L, Ciardo L, Martella B, Militello C, Nistri R, Spirch S, Terranova O. [Physiopathology of intestinal anastomoses and dehiscences]. Chir Ital 1997; 49:5-10. [PMID: 10392176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
A lot of mechanisms of healing of intestinal anastomoses has been explained. A leading role in the intestinal wall is made by the submucosal tunica, where collagen synthesis and degradation process take place, but local and systemic factors are present by a definite causal action. Technique of suture, materials and surgeon's experience are of fundamental importance for the success of operation, even if in some cases it is important to take in consideration the clinical situation: emergency or not, the patient's state and age, concomitant diseases, pharmacological or radiotherapeutic treatments. Nowadays surgical research tends towards biochemical and molecular field to identify the factors, that speed up the healing process to use them in suturing materials getting a quick healing as soon as possible.
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Affiliation(s)
- L De Santis
- Clinica Chirurgica Geriatrica, Università degli Studi di Padova
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Nistri R, Martella B, De Santis L, Spirch S, Militello C, Terranova O. [Breast cancer in elderly women]. Chir Ital 1997; 49:31-6. [PMID: 10392181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Breast cancer represents an important epidemiological and clinical problem, and the elderly age represents a large proportion of women with breast cancer. In patients older than 65-year, the frequency of breast cancer is 50% and more. Early diagnosis and adequate therapy may play an important role also in the elderly. We performed a retrospective analysis of 146 women older than 65-year to determine the effect of age in management of the disease.
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Affiliation(s)
- R Nistri
- Clinica Chirurgica Geriatrica, Università degli Studi di Padova
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Terranova O, Battocchio F, Martella B, Celi D. Anal fistulas with recess above the anal levators. Int Surg 1989; 74:267-9. [PMID: 2625403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The Authors present their experience with anal fistulas with recess above the levators. They mainly analyze the diagnostic, clinical, instrumental and therapeutic problems which this type of anal fistula may present.
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Affiliation(s)
- O Terranova
- Chirurgia Geriatrica, Università di Padova, Italy
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Terranova O, Celi D, Martella B, Battocchio F. Local recurrence of rectal cancer: anterior resection versus abdomino-perineal resection. Int Surg 1989; 74:111-3. [PMID: 2753619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Local recurrences of rectal cancer after surgical therapy are a mainly diagnostic and therapeutic problem. The Authors report their experience in local recurrences of rectal cancer. They consider anterior resection versus abdomino-perineal resection, the type of anastomosis and the stage of primary disease. Follow-up is discussed emphasizing early diagnosis for local recurrences.
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Affiliation(s)
- O Terranova
- Chirurgia Geriatrica, Università di Padova, Padua, Italy
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Terranova O, Meneghello A, Battocchio F, Martella B, Celi D, Nistri R. Perforations of the extraperitoneal rectum during barium enema. Int Surg 1989; 74:13-6. [PMID: 2707992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Rectal injuries during barium enema are uncommon but not unusual complications. Radiologists and surgeons must be able to recognize them, as early diagnosis is essential for effective treatment. The Authors discuss various aspects of problems arising from rectal perforation, and report their experience on seven cases.
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Affiliation(s)
- O Terranova
- Chirurgia Geriatrica, Università di Padova, Italy
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Peracchia A, Ancona E, Bardini R, Martella B, Sorrentino P, Tremolada C. [Esophagojejunoplasty with partial rechannelization of the duodenum after total gastrectomy]. MINERVA CHIR 1982; 37:1475-80. [PMID: 7145147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Bardini R, Martella B, Rossi M, Cusumano A, Sorrentino P. [Achalasia of the gastric tube in esophagoplasty using the Gavriliu technic (presentation of a clinical case)]. Chir Ital 1981; 33:873-7. [PMID: 7326810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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