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Purpose: Predicting feasibility of treatment in older patients with cancer is a major clinical task. The Initiative Geriatrische Hämatologie und Onkologie (IN-GHO ® ) registry prospectively collected data on the comprehensive geriatric assessment (CGA), physician's and patient's-self assessment of fitness for treatment, and the course of treatment in patients within a treatment decision aged ≥ 70 years., Patients and Methods: The registry included 3169 patients from 93 centres and evaluated clinical course and treatment outcomes 2-3 and 6 months after initial assessment. Fitness for treatment was classified as fit, compromised and frail according to results of a CGA, and in addition by an experienced physician's and by patient's itself. Feasibility of treatment (termed IN-GHO ® -FIT) was defined as a composite endpoint, including willingness to undergo the same treatment again in retrospect, no modification or unplanned termination of treatment, and no early mortality (within 90 days)., Results: CGA classified 30.0% as fit, 35.8% as compromised, and 34.2% as frail. Physician's and patient's-self assessment classified 61.8%/52.3% as fit, 34.2%/42.4% as compromised, and 3.9%/5.3%, as frail, respectively. Survival status at day 180 was available in 2072 patients, of which 625 (30.2%) had died. After 2-3 months, feasibility of treatment could be assessed in 1984 patients. 62.8% fulfilled IN-GHO®-FIT criteria. Multivariable analysis identified physician's assessment as the single most important item regarding feasibility of treatment., Conclusion: Geriatricians were involved in 2% of patients only. Classification of fitness for treatment by CGA, and physician's or patient's-self assessment showed marked discrepancies. For the prediction of feasibility of treatment no single item was superior to physician's assessment. However CGA was not performed by trained geriatricians., (© 2021. The Author(s).)

Purpose: With the increasing number of elderly patients suffering from cancer, comorbidity and functional impairment become common problems in patients with cancer. Both comorbidity and functional impairment are associated with a shorter survival time in cancer patients, but their independent role has rarely been addressed before., Methods: Within a prospective trial we recruited 427 cancer patients, irrespective of age and type of cancer, admitted as inpatients prior to the start of chemotherapy. Comorbidity was assessed with the cumulative illness rating scale (CIRS-G), functional impairment with WHO performance status (WHO-PS), basal (ADL) and instrumental (IADL) activities of daily living., Results: Median follow-up was 34.2 months. A total, 61.4%. of patients died. Median survival time was 21.0 months. Age, kind of tumour (solid vs. haematological), treatment approach (non-curative vs. curative), WHO-PS (2-4 vs. 0-1), IADL (<8 vs. 8), and severe comorbidity (CIRS-level 3-4 vs. none) were significantly associated with shorter survival time in univariate analysis. In a multivariate Cox-regression-analysis, age (HR 1.019; 95%-CI 1.007-1.032; P=0.003), kind of tumour (HR 1.832; 95%-CI 1.314-2.554; P<0.001), WHO-PS (HR 1.455; 95%-CI 1.059-2.000; P=0.021), and comorbidity level 3-4 (HR 1.424; 95%-CI 1.012-2.003; P=0.043) maintained their significant association., Conclusions: Age, severe comorbidity, functional impairment, and kind of tumour are independently related to shorter survival time in cancer patients.

Purpose: Quality of life (QoL) of patients with cancer is a major area of concern for both patients and their physicians., Patients and Methods: We investigated QoL with the EORTC-QLQ-C30 questionnaire with reference to anaemia and Karnofsky Performance Status (KPS) prior to the start of chemotherapy in 477 patients: 195 elderly cancer patients (Group A), 152 younger cancer patients (Group B), and 130 patients aged 60 years or older admitted for non-cancer related disorders (Group C)., Results: In univariate analysis QoL was significantly worse in 8 out of 15 scales in anaemic compared to non anaemic patients in Group A, in 2 in Group B, and in 7 in Group C. In ANOVA analysis including KPS and haemoglobin status, the influence of anaemia and KPS independently persists in most scales in Group A, in some in Group C, but not in Group B., Conclusions: Anaemia and functional impairment are independently related to QoL in elderly cancer and elderly medical patients, but not in younger cancer patients.