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Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Pinto A, Custodio AB, del Mar Muñoz M, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O, Molina-Garrido MJ. Prediction of Chemotoxicity, Unplanned Hospitalizations and Early Death in Older Patients with Colorectal Cancer Treated with Chemotherapy. Cancers (Basel) 2021; 14:cancers14010127. [PMID: 35008291 PMCID: PMC8749992 DOI: 10.3390/cancers14010127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Chemotoxicity, unplanned hospitalizations (Uhs) and early death (ED) are common among older patients with cancer who receive chemotherapy. Our objective was to determine factors predicting these complications. A predictive score for these three complications based on geriatric, tumor and laboratory variables was developed in a series of 215 older patients with colorectal carcinoma receiving chemotherapy. The use of this score may reliably identify patients at risk to have excessive toxicity with chemotherapy, UH or ED, thus helping to plan treatment, implement adaptive measures, and intensify follow-up. Abstract Purpose: To identify risk factors for toxicity, unplanned hospitalization (UH) and early death (ED) in older patients with colorectal carcinoma (CRC) initiating chemotherapy. Methods: 215 patients over 70 years were prospectively included. Geriatric assessment was performed before treatment, and tumor and treatment variables were collected. The association between these factors and grade 3–5 toxicity, UH and ED (<6 months) was examined by using multivariable logistic regression. Score points were assigned to each risk factor. Results: During the first 6 months of treatment, 33% of patients developed grade 3–5 toxicity, 31% had UH and 23% died. Risk factors were, for toxicity, instrumental activities of daily living, creatinine clearance, weight loss and MAX2 index; for UH, Charlson Comorbidity Score, creatinine clearance, weight loss, serum albumin, and metastatic disease; and for ED, basic activities in daily living, weight loss, metastatic disease, and hemoglobin levels. Predictive scores were built with these variables. The areas under receiver operation characteristic (ROC) curves for toxicity, UH and ED were 0.70 (95% CI: 0.64–0.766), 0.726 (95% IC: 0.661–0.799) and 0.74 (95% IC: 0.678–0.809), respectively. Conclusion: Simple scores based on geriatric, tumor and laboratory characteristics predict severe toxicity, UH and ED, and may help in treatment planning.
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Affiliation(s)
- Jaime Feliu
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
- Correspondence: ; Tel./Fax: +3-491-727-7118
| | - Enrique Espinosa
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Laura Basterretxea
- Oncology Department, Donostia University Hospital, 20014 Donostia, Spain; (L.B.); (J.G.-M.)
| | - Irene Paredero
- Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain; (I.P.); (M.-D.T.)
| | - Elisenda Llabrés
- Oncology Department, Insular University Hospital of Gran Canarias, 35016 Las Palmas, Spain;
| | | | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Beatriz Losada
- Oncology Department, University Hospital of Fuenlabrada, 28942 Madrid, Spain;
| | - Alvaro Pinto
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Ana Belén Custodio
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - María del Mar Muñoz
- Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain; (M.d.M.M.); (M.-J.M.-G.)
| | | | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Patricia Cruz
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Oliver Higuera
- Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
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Feliu J, Pinto A, Basterretxea L, López-San Vicente B, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Espinosa E, Gironés R, Custodio AB, Muñoz MDM, Díaz-Almirón M, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O, González-Montalvo JI, Molina-Garrido MJ. Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer. J Clin Med 2021; 10:jcm10081615. [PMID: 33920250 PMCID: PMC8070509 DOI: 10.3390/jcm10081615] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Estimation of life expectancy in older patients is relevant to select the best treatment strategy. We aimed to develop and validate a score to predict early mortality in older patients with cancer. Patients and Methods: A total of 749 patients over 70 years starting new chemotherapy regimens were prospectively included. A prechemotherapy assessment that included sociodemographic variables, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and early death was examined using multivariable logistic regression. Score points were assigned to each risk factor. External validation was performed on an independent cohort. Results: In the training cohort, the independent predictors of 6-month mortality were metastatic stage (OR 4.8, 95% CI [2.4–9.6]), ECOG-PS 2 (OR 2.3, 95% CI [1.1–5.2]), ADL ≤ 5 (OR 1.7, 95% CI [1.1–3.5]), serum albumin levels ≤ 3.5 g/dL (OR 3.4, 95% CI [1.7–6.6]), BMI < 23 kg/m2 (OR 2.5, 95% CI [1.3–4.9]), and hemoglobin levels < 11 g/dL (OR 2.4, 95% CI (1.2–4.7)). With these results, we built a prognostic score. The area under the ROC curve was 0.78 (95% CI, 0.73 to 0.84), and in the validation set, it was 0.73 (95% CI: 0.67–0.79). Conclusions: This simple and highly accurate tool can help physicians making decisions in elderly patients with cancer who are planned to initiate chemotherapy treatment.
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Affiliation(s)
- Jaime Feliu
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
- Correspondence: ; Tel./Fax: +3-491-727-7118
| | - Alvaro Pinto
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - Laura Basterretxea
- Oncology Department, OSI Donostialde, Donostia Unibertsitate Ospitalea, Donostialde, Donostia, 20014 Gipuzkoa, Spain; (L.B.); (J.G.-M.)
| | | | - Irene Paredero
- Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain; (I.P.); (M.D.T.)
| | - Elisenda Llabrés
- Oncology Department, Hospital Universitario Insular de Gran Canarias, 35016 Las Palmas, Spain;
| | | | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL, Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Beatriz Losada
- Oncology Department, Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain;
| | - Enrique Espinosa
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - Regina Gironés
- Oncology Department, Hospital Universitari y Politécnic La Fé, 46026 Valencia, Spain;
| | - Ana Belén Custodio
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - María del Mar Muñoz
- Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain; (M.d.M.M.); (M.J.M.-G.)
| | - Mariana Díaz-Almirón
- Biostatistics Department, Hospital La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain;
| | - Jenifer Gómez-Mediavilla
- Oncology Department, OSI Donostialde, Donostia Unibertsitate Ospitalea, Donostialde, Donostia, 20014 Gipuzkoa, Spain; (L.B.); (J.G.-M.)
| | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d’Oncologia, IDIBELL, Hospitalet, 08908 Barcelona, Spain; (M.A.-R.); (G.S.)
| | - Patricia Cruz
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
| | - Oliver Higuera
- Oncology Department, Hospital Universitario La Paz, IDIPAZ, Cátedra UAM-AMGEN, CIBERONC, 28046 Madrid, Spain; (A.P.); (E.E.); (A.B.C.); (P.C.); (O.H.)
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Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Losada B, Pinto A, Custodio AB, Muñoz MDM, Gómez-Mediavilla J, Torregrosa MD, Cruz P, Higuera O, Molina-Garrido MJ. Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy. Cancers (Basel) 2021; 13:1437. [PMID: 33809852 PMCID: PMC8004134 DOI: 10.3390/cancers13061437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To determine the incidence of unplanned hospitalization (UH) and to identify risk factors for UH in elderly patients with cancer who start chemotherapy. METHODS In all, 493 patients over 70 years starting new chemotherapy regimens were prospectively included. A pre-chemotherapy geriatric assessment was performed, and tumor and treatment variables were collected. The association between these factors and UH was examined by using multivariable logistic regression. Score points were assigned to each risk factor. RESULTS During the first 6 months of treatment, 37% of patients had at least one episode of UH. Risk factors were the use of combination chemotherapy at standard doses, a MAX2 index ≥1, a Charlson comorbidity score ≥2, albumin level <3.5 g/dL, falls in the past 6 months ≥1, and weight loss >5%. Three risk groups for UH were established according to the score in all patients: 0-1: 17.5%; 2: 34%; and 3-7: 57% (p < 0.001). The area under receiver operation characteristic (ROC) curve was 0.72 (95% CI: 0.67-0.77). CONCLUSION This simple tool can help to reduce the incidence of UH in elderly patients with cancer who are scheduled to initiate chemotherapy treatment.
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Affiliation(s)
- Jaime Feliu
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Enrique Espinosa
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Laura Basterretxea
- Oncology Department, Hospital Universitario de Donostia, 20014 Donostia, Spain; (L.B.); (J.G.-M.)
| | - Irene Paredero
- Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain; (I.P.); (M.D.T.)
| | - Elisenda Llabrés
- Oncology Department, Hospital Universitario Insular de Gran Canarias, 35016 Las Palmas, Spain;
| | | | - Beatriz Losada
- Oncology Department, Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain;
| | - Alvaro Pinto
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Ana Belén Custodio
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - María del Mar Muñoz
- Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain; (M.d.M.M.); (M.J.M.-G.)
| | | | | | - Patricia Cruz
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
| | - Oliver Higuera
- Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain; (E.E.); (A.P.); (A.B.C.); (P.C.); (O.H.)
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Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Pinto A, Gironés R, Custodio AB, Muñoz MDM, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O, Molina-Garrido MJ. Undertreatment and overtreatment in older patients treated with chemotherapy. J Geriatr Oncol 2020; 12:381-387. [PMID: 33109485 DOI: 10.1016/j.jgo.2020.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/02/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Inconsistent doses and schemes are commonly used in older patients receiving cancer chemotherapy. We performed this study in patients with cancer and age ≥ 70 years to determine the frequency of undertreatment and overtreatment as well as factors influencing the decision to modify chemotherapy doses. PATIENTS AND METHODS Patients aged ≥70 years starting new chemotherapy regimens were prospectively included in a multicentre study. The schedule and drug doses were determined by the treating oncologist. Pre-chemotherapy assessment included sociodemographics, treatment details and geriatric assessment (GA) variables. Association between these factors and undertreatment (use of less intensive cancer treatment [LICT] in a fit patient) or overtreatment (use of standard cancer treatment in an unfit older patient) were examined by multivariate logistic regression. RESULTS Three- hundred ninety-seven patients were included, 43% of whom received LICT. If not adjusted for GA, toxicity did not differ between those receiving LICT (38%) or standard doses of chemotherapy (37%). If the dose of chemotherapy was analyzed according to the results of GA 61 (15%) patients had been undertreated and 133 (34%) had been overtreated. Undertreatment was related with increasing age and decreased renal function. Factors related with overtreatment were younger age, curative intention of treatment, prescription of G-CSF as primary prophylaxis and adequate cognitive status. Overtreated patients had more grade 3-4 toxicity than those receiving treatment adapted to fragility (42% vs 31%; p < 0.05). CONCLUSIONS The use of chemotherapy without considering GA leads to overtreatment more commonly than undertreatment in older patients with cancer. Oncologists should take into account the results of GA to stratify patients and to avoid under or overtreatment.
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Affiliation(s)
- Jaime Feliu
- Oncology department, Hospital Universitario La Paz, Madrid, Spain; Cátedra UAM-AMGEN, CIBERONC, Spain.
| | - Enrique Espinosa
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
| | | | - Irene Paredero
- Oncology department, Hospital Universitario Dr. Peset. Valencia, Spain
| | - Elisenda Llabrés
- Oncology department, Hospital Universitario Insular de Gran Canarias, Spain
| | | | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL, Hospitalet, Barcelona, Spain
| | - Beatriz Losada
- Oncology department, Hospital Universitario de Fuenlabrada, Spain
| | - Alvaro Pinto
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
| | - Regina Gironés
- Oncology department, Hospital Universitari y Politécnic La Fé, Valencia, Spain
| | | | | | | | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL, Hospitalet, Barcelona, Spain
| | - Patricia Cruz
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
| | - Oliver Higuera
- Oncology department, Hospital Universitario La Paz, Madrid, Spain
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Feliu J, Jiménez-Munárriz B, Basterretxea L, Paredero I, Llabrés E, Antonio-Rebollo M, Losada B, Espinosa E, Gironés R, Custodio AB, Del Mar Muñoz M, Díaz-Almirón M, Gómez-Mediavilla J, Pinto A, Torregrosa MD, Soler G, Cruz P, Higuera O, Molina-Garrido MJ. Predicting Chemotherapy Toxicity in Older Patients with Cancer: A Multicenter Prospective Study. Oncologist 2020; 25:e1516-e1524. [PMID: 32329131 DOI: 10.1634/theoncologist.2019-0701] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/24/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Standard oncology tools are inadequate to distinguish which older patients are at higher risk of developing chemotherapy-related complications. MATERIALS AND METHODS Patients over 70 years of age starting new chemotherapy regimens were prospectively included in a multicenter study. A prechemotherapy assessment that included sociodemographics, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and the development of grade 3-5 toxicity was examined by using logistic regression. RESULTS A total of 551 patients were accrued. Chemotherapy doses (odds ratio [OR] 1.834; 95% confidence interval [CI] 1.237-2.719) and creatinine clearance (OR 0.989; 95% CI 0.981-0.997) were the only factors independently associated with toxicity. Only 19% of patients who received reduced doses of chemotherapy and had a creatinine clearance ≥40 mL/minute had grade 3-4 toxicity, compared with 38% of those who received standard doses or had a creatinine clearance <40 mL/minute (p < .0001). However, no satisfactory multivariate model was obtained using different selection approaches. CONCLUSION Chemotherapy doses and renal function were identified as the major risk factors for developing severe toxicity in the older patient. These factors should be considered when planning to initiate a new chemotherapy regimen and should also lead to a closer follow-up in these patients. IMPLICATIONS FOR PRACTICE Older patients are more vulnerable to chemotherapy toxicity. However, standard tools are inadequate to identify who is at higher risk of developing chemotherapy-related complications. Chemotherapy doses (standard vs. reduced) and renal function were identified as the major risk factors for developing severe toxicity in the elderly. These factors should be considered when planning to initiate a new chemotherapy regimen and should also lead to a closer follow-up.
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Affiliation(s)
- Jaime Feliu
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | | | | | - Irene Paredero
- Oncology Department, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Elisenda Llabrés
- Oncology Department, Hospital Universitario Insular de Gran Canarias, Las Palmas, Spain
| | - Maite Antonio-Rebollo
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL Hospitalet, Barcelona, Spain
| | - Beatriz Losada
- Oncology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Enrique Espinosa
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | - Regina Gironés
- Oncology Department, Hospital Lluis Alcanyis de Xátiva, Valencia, Spain
| | - Ana Belén Custodio
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | | | - Mariana Díaz-Almirón
- Biostatistics Department, Hospital La Paz, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alvaro Pinto
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | | | - Gema Soler
- Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL Hospitalet, Barcelona, Spain
| | - Patricia Cruz
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
| | - Oliver Higuera
- Oncology Department, Hospital Universitario La Paz, Cátedra UAM-AMGEN, CIBERONC, Madrid, Spain
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Manzanedo I, Losada B, Martínez-Torres B, Pereira F, Serrano Á, Juez I, Pérez-Viejo E, Gutiérrez D, Peiró V, Aulló C. Validation of diagnostic methods for peritoneal carcinomatosis secondary to ovarian cancer. CT-scan, PET-CT or laparoscopy, what is the best? Minerva Obstet Gynecol 2018; 70:488-490. [PMID: 29431339 DOI: 10.23736/s0026-4784.18.04182-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Israel Manzanedo
- Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain - .,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain - .,Rey Juan Carlos University (URJC), Madrid, Spain -
| | - Beatriz Losada
- Rey Juan Carlos University (URJC), Madrid, Spain.,Department of Medical Oncology, Fuenlabrada University Hospital, Madrid, Spain
| | - Beatriz Martínez-Torres
- Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
| | - Fernando Pereira
- Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
| | - Ángel Serrano
- Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
| | - Ignacio Juez
- Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain.,Department of Medical Oncology, Fuenlabrada University Hospital, Madrid, Spain
| | - Estíbalitz Pérez-Viejo
- Department of General and Digestive Surgery. Fuenlabrada University Hospital, Madrid, Spain.,Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Rey Juan Carlos University (URJC), Madrid, Spain
| | - David Gutiérrez
- Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Department of Medical Oncology, Fuenlabrada University Hospital, Madrid, Spain
| | - Virginia Peiró
- Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Department of Nuclear Medicine, Fuenlabrada University Hospital, Madrid, Spain
| | - Carolina Aulló
- Unit of Peritoneal Carcinomatosis, Fuenlabrada University Hospital, Madrid, Spain.,Department of Radiology, Fuenlabrada University Hospital, Madrid, Spain
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Gironés R, Morilla I, Guillen-Ponce C, Torregrosa MD, Paredero I, Bustamante E, Del Barco S, Soler G, Losada B, Visa L, Llabrés E, Fox B, Firvida JL, Blanco R, Antonio M, Aparisi F, Pi-Figueras M, Gonzalez-Flores E, Molina-Garrido MJ, Saldaña J. Geriatric oncology in Spain: survey results and analysis of the current situation. Clin Transl Oncol 2017; 20:1087-1092. [PMID: 29327240 PMCID: PMC6061214 DOI: 10.1007/s12094-017-1813-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 11/16/2017] [Indexed: 11/30/2022]
Abstract
Introduction Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. Objectives The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. Methods A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. Results Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. Conclusions From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.
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Affiliation(s)
- R Gironés
- Medical Oncology Unit. Hospital Lluís Alcanyís, Crta Xàtiva A Silla Km 2, Xàtiva, 46800, Valencia, Spain.
| | - I Morilla
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | | | | | - I Paredero
- Hospital Universitario Dr Peset, Valencia, Spain
| | - E Bustamante
- Althaia, Xarxa Assistencial I Universitaria Manresa, Barcelona, Spain
| | - S Del Barco
- Hospital Universitari Dr. Josep Trueta. ICO Girona, Girona, Spain
| | - G Soler
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | - B Losada
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - L Visa
- Hospital Del Mar, Barcelona, Spain
| | - E Llabrés
- Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | - B Fox
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J L Firvida
- Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - R Blanco
- Consorci Sanitari de Terrassa, Barcelona, Spain
| | - M Antonio
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | - F Aparisi
- Hospital General de Valencia, Valencia, Spain
| | | | | | | | - J Saldaña
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
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Machado P, Castrejon I, Katchamart W, Koevoets R, Kuriya B, Schoels M, Silva-Fernández L, Thevissen K, Vercoutere W, Villeneuve E, Aletaha D, Carmona L, Landewé R, van der Heijde D, Bijlsma JWJ, Bykerk V, Canhão H, Catrina AI, Durez P, Edwards CJ, Mjaavatten MD, Leeb BF, Losada B, Martín-Mola EM, Martinez-Osuna P, Montecucco C, Müller-Ladner U, Østergaard M, Sheane B, Xavier RM, Zochling J, Bombardier C. Multinational evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative. Ann Rheum Dis 2010; 70:15-24. [PMID: 20724311 PMCID: PMC3002765 DOI: 10.1136/ard.2010.130625] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective To develop evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis (UPIA). Methods 697 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2008–9 consisting of three separate rounds of discussions and modified Delphi votes. In the first round 10 clinical questions were selected. A bibliographic team systematically searched Medline, Embase, the Cochrane Library and ACR/EULAR 2007–2008 meeting abstracts. Relevant articles were reviewed for quality assessment, data extraction and synthesis. In the second round each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results A total of 39 756 references were identified, of which 250 were systematically reviewed. Ten multinational key recommendations about the investigation and follow-up of UPIA were formulated. One recommendation addressed differential diagnosis and investigations prior to establishing the operational diagnosis of UPIA, seven recommendations related to the diagnostic and prognostic value of clinical and laboratory assessments in established UPIA (history and physical examination, acute phase reactants, autoantibodies, radiographs, MRI and ultrasound, genetic markers and synovial biopsy), one recommendation highlighted predictors of persistence (chronicity) and the final recommendation addressed monitoring of clinical disease activity in UPIA. Conclusions Ten recommendations on how to investigate and follow-up UPIA in the clinical setting were developed. They are evidence-based and supported by a large panel of rheumatologists, thus enhancing their validity and practical use.
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Affiliation(s)
- P Machado
- Department of Rheumatology, Coimbra University Hospital, Coimbra, Portugal.
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Losada B, García-Rebollar P, Álvarez C, Cachaldora P, Ibáñez M, Méndez J, De Blas J. The prediction of apparent metabolisable energy content of oil seeds and oil seed by-products for poultry from its chemical components, in vitro analysis or near-infrared reflectance spectroscopy. Anim Feed Sci Technol 2010. [DOI: 10.1016/j.anifeedsci.2010.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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García-Lavandeira J, Losada B, Martínez-Pontevedra J, Lores M, Cela R. Computer-assisted method development in liquid chromatography–mass spectrometry: New proposals. J Chromatogr A 2008; 1208:116-25. [DOI: 10.1016/j.chroma.2008.08.105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Revised: 08/18/2008] [Accepted: 08/20/2008] [Indexed: 10/21/2022]
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