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4. Current Challenges and Perspectives in Breast Cancer in Elderly Women: The Senologic International Society (SIS) Survey

Author

Scheer, Louise, primary, Lodi, Massimo, additional, Özmen, Tolga, additional, Alghamdi, Khalid, additional, Anyanwu, Stanley, additional, Birendra, Joshi, additional, Boubnider, Mohsen, additional, Costa, Mauricio, additional, Dian, Darius, additional, Elder, Elisabeth, additional, Gebrim, Luiz Henrique, additional, Guo, Xiaojing, additional, Heitz, Damien, additional, Imoto, Shigeru, additional, Ioannidou-Mouzaka, Lydia, additional, Kaufman, Cary, additional, Liu, Hong, additional, Mbodj, Mamadou, additional, Meka, Esther, additional, Mundinger, Alexander, additional, Novelli, Jorge, additional, Ojuka, Daniel, additional, Orda, Ruben, additional, Ostapenko, Valerijus, additional, Pieńkowski, Tadeusz, additional, Podolski, Paula, additional, Vogel, Thomas, additional, Yin, Jian, additional, Özmen, Vahit, additional, Schneebaum, Schlomo, additional, and Mathelin, Carole, additional

Published
2023
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5. Current Challenges and Perspectives in Breast Cancer in Elderly Women: The Senologic International Society (SIS) Survey

Author

Scheer, Louise, Lodi, Massimo, Özmen, Tolga, Alghamdi, Khalid, Anyanwu, Stanley, Birendra, Joshi, Boubnider, Mohsen, Costa, Mauricio, Dian, Darius, Elder, Elisabeth, Gebrim, Luiz Henrique, Guo, Xiaojing, Heitz, Damien, Imoto, Shigeru, Ioannidou-Mouzaka, Lydia, Kaufman, Cary, Liu, Hong, Mbodj, Mamadou, Meka, Esther, Mundinger, Alexander, Novelli, Jorge, Ojuka, Daniel, Orda, Ruben, Ostapenko, Valerijus, Pieńkowski, Tadeusz, Podolski, Paula, Vogel, Thomas, Yin, Jian, Özmen, Vahit, Schneebaum, Schlomo, and Mathelin, Carole

Subjects
Original Article
Abstract

OBJECTIVE: Mammographic screening and management of breast cancer (BC) in elderly women are controversial and continue to be an important health problem. To investigate, through members of the Senologic International Society (SIS), the current global practices in BC in elderly women, highlighting topics of debate and suggesting perspectives. MATERIALS AND METHODS: The questionnaire was sent to the SIS network and included 55 questions on definitions of an elderly woman, BC epidemiology, screening, clinical and pathological characteristics, therapeutic management in elderly women, onco-geriatric assessment and perspectives. RESULTS: Twenty-eight respondents from 21 countries and six continents, representing a population of 2.86 billion, completed and submitted the survey. Most respondents considered women 70 years and older to be elderly. In most countries, BC was often diagnosed at an advanced stage compared to younger women, and age-related mortality was high. For this reason, participants recommended that personalized screening be continued in elderly women with a long life expectancy. In addition, this survey highlighted that geriatric frailty assessment tools and comprehensive geriatric evaluations needed to be used more and should be developed to avoid undertreatment. Similarly, multidisciplinary meetings dedicated to elderly women with BC should be encouraged to avoid under- and over-treatment and to increase their participation in clinical trials. CONCLUSION: Due to increased life expectancy, BC in elderly women will become a more important field in public health. Therefore, screening, personalized treatment, and comprehensive geriatric assessment should be the cornerstones of future practice to avoid the current excess of age-related mortality. This survey described, through members of the SIS, a global picture of current international practices in BC in elderly women.

Published
2023

9. Prognostic Value of Routinely Measured Inflammatory Biomarkers in Older Cancer Patients: Pooled Analysis of Three Cohorts

Author

Oubaya, Nadia, primary, Soubeyran, Pierre, additional, Reinald, Nicoleta, additional, Fonck, Marianne, additional, Allain, Mylène, additional, Zebachi, Sonia, additional, Heitz, Damien, additional, Laurent, Marie, additional, Delattre, Cécile, additional, Caillet, Philippe, additional, Dauba, Jérôme, additional, Bastuji-Garin, Sylvie, additional, Albrand, Gilles, additional, Bringuier, Michael, additional, Rainfray, Muriel, additional, Brain, Etienne, additional, Grellety, Thomas, additional, Paillaud, Elena, additional, Mathoulin-Pélissier, Simone, additional, Bellera, Carine, additional, and Canouï-Poitrine, Florence, additional

Published
2021
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11. Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer)

Author

Poisson, Johanne, primary, Martinez‐Tapia, Claudia, additional, Heitz, Damien, additional, Geiss, Romain, additional, Albrand, Gilles, additional, Falandry, Claire, additional, Gisselbrecht, Mathilde, additional, Couderc, Anne‐Laure, additional, Boulahssass, Rabia, additional, Liuu, Evelyne, additional, Boudou‐Rouquette, Pascaline, additional, Chah Wakilian, Anne, additional, Gaxatte, Cedric, additional, Pamoukdjian, Fréderic, additional, de Decker, Laure, additional, Antoine, Valery, additional, Cattenoz, Catherine, additional, Solem‐Laviec, Heidi, additional, Guillem, Olivier, additional, Medjenah, Hayat, additional, Natella, Pierre André, additional, Canouï‐Poitrine, Florence, additional, Laurent, Marie, additional, and Paillaud, Elena, additional

Published
2021
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12. Indicateurs précoces de durée de séjour prolongée chez les sujets âgés: Étude pilote réalisée au CHRU de Strasbourg

Author

Lang, Pierre-Olivier, Heitz, Damien, Meyer, Nicolas, Dramé, Moustapha, Jovenin, Nicolas, Ankri, Joël, Somme, Dominique, Novella, Jean-Luc, Gauvain, Jean-Bernard, Colvez, Alain, Couturier, Pascal, Lanièce, Isabelle, Voisin, Thierry, de Wazières, Benoit, Gonthier, Régis, Jeandel, Claude, Jolly, Damien, Saint-Jean, Olivier, and Blanchard, François

Published
2007
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16. Prognostic value of routine biomarkers in older patients with cancer: Pooled analysis of three prospective cohorts.

Author

Paillaud, Elena, primary, Soubeyran, Pierre, additional, Oubaya, Nadia, additional, Brain, Etienne, additional, Fonck, Marianne, additional, Reinald, Nicoleta, additional, Heitz, Damien, additional, Allain, Mylene, additional, Zebachi, Sonia, additional, Rousselot, Hubert, additional, Laurent, Marie, additional, Dauba, Jérôme, additional, Caillet, Philippe, additional, Bastuji-Garin, Sylvie, additional, Rainfray, Muriel, additional, Bringuier, Michael, additional, Grellety, Thomas, additional, Bellera, Carine A., additional, Mathoulin-Pélissier, Simone, additional, and Canoui-Poitrine, Florence, additional

Published
2019
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17. Impact of a multifaceted program to prevent postoperative delirium in the elderly: the CONFUCIUS stepped wedge protocol

Author

Bonnefoy Marc, Fassier Thomas, Duclos Antoine, Rippert Pascal, Mouchoux Christelle, Comte Brigitte, Heitz Damien, Colin Cyrille, and Krolak-Salmon Pierre

Subjects
Geriatrics, RC952-954.6
Abstract

Abstract Background Postoperative delirium is common in the elderly and is associated with a significant increase in mortality, complications, length of hospital stay and admission in long care facility. Although several interventions have proved their effectiveness to prevent it, the Cochrane advises an assessment of multifaceted intervention using rigorous methodology based on randomized study design. Our purpose is to present the methodology and expected results of the CONFUCIUS trial, which aims to measure the impact of a multifaceted program on the prevention of postoperative delirium in elderly. Method/Design Study design is a stepped wedge cluster randomized trial within 3 surgical wards of three French university hospitals. All patients aged 75 and older, and admitted for scheduled surgery will be included. The multifaceted program will be conducted by mobile geriatric team, including geriatric preoperative consultation, training of the surgical staff and implementation of the Hospital Elder Life Program, and morbidity and mortality conference related to delirium cases. The primary outcome is based on postoperative delirium rate within 7 days after surgery. This program is planned to be implemented along four successive time periods within all the surgical wards. Each one will be affected successively to the control arm and to the intervention arm of the trial and the order of program introduction within each surgical ward will be randomly assigned. Based on a 20% reduction of postoperative delirium rate (ICC = 0.25, α = 0.05, β = 0.1), three hundred sixty patients will be included i.e. thirty patients per service and per time period. Endpoints comparison between intervention and control arms of the trial will be performed by considering the cluster and time effects. Discussion Better prevention of delirium is expected from the multifaceted program, including a decrease of postoperative delirium, and its consequences (mortality, morbidity, postoperative complications and length of hospital stay) among elderly patients. This study should allow better diagnosis of delirium and strengthen the collaboration between surgical and mobile geriatric teams. Should the program have a substantial impact on the prevention of postoperative delirium in elderly, it could be extended to other facilities. Trial registration ClinicalTrials.gov: NCT01316965

Published
2011
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19. Loss of independence in Katz's ADL ability in connection with an acute hospitalization: early clinical markers in French older people

Author

Lang, Pierre-Olivier, Meyer, Nicolas, Heitz, Damien, Dramé, Moustapha, Jovenin, Nicolas, Ankri, Joël, Somme, Dominique, Novella, Jean-Luc, Gauvain, Jean-Bernard, Couturier, Pascal, Lanièce, Isabelle, Voisin, Thierry, de Wazières, Benoit, Gonthier, Régis, Jeandel, Claude, Jolly, Damien, Saint-Jean, Olivier, Blanchard, François, Lang, Pierre-Olivier, Meyer, Nicolas, Heitz, Damien, Dramé, Moustapha, Jovenin, Nicolas, Ankri, Joël, Somme, Dominique, Novella, Jean-Luc, Gauvain, Jean-Bernard, Couturier, Pascal, Lanièce, Isabelle, Voisin, Thierry, de Wazières, Benoit, Gonthier, Régis, Jeandel, Claude, Jolly, Damien, Saint-Jean, Olivier, and Blanchard, François

Abstract

Background: The preservation of autonomy and the ability of elderly to carry out the basic activities of daily living, beyond the therapeutic care of any pathologies, appears as one of the main objectives of care during hospitalization. Objectives: To identify early clinical markers associated with the loss of independence in elderly people in short stay hospitals. Methods: Among the 1,306 subjects making up the prospective and multicenter SAFEs cohort study (Sujet Agé Fragile: Évolution et suivi—Frail elderly subjects, evaluation and follow-up), 619 medical inpatients, not disabled at baseline and hospitalized through an emergency department were considered. Data used in a multinomial logistic regression were obtained through a comprehensive geriatric assessment (CGA) conducted in the first week of hospitalization. Dependency levels were assessed at baseline, at inclusion and at 30days using Katz's ADL index. Baseline was defined as the dependence level before occurrence of the event motivating hospitalization. To limit the influence of rehabilitation on the level of dependence, only stays shorter than 30days were considered. Results: About 514 patients were eligible, 15 died and 90 were still hospitalized at end point (n=619). Two-thirds of subjects were women, with a mean age of 83. At day 30 162 patients (31%) were not disabled; 61 (12%) were moderately disabled and 291 severely disabled (57%). No socio-demographic variables seemed to influence the day 30 dependence level. Lack of autonomy (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.2-3.6), walking difficulties (OR=2.7, 95% CI=1.3-5.6), fall risk (OR=2.1, 95% CI=1.3-6.8) and malnutrition risk (OR=2.2, 95% CI=1.5-7.6) were found in multifactorial analysis to be clinical markers for loss of independence. Conclusions: Beyond considerations on the designing of preventive policies targeting the populations at risk that have been identified here, the identification of functional factors (lack of autonomy, wal

Published
2018

22. Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study

Author

Soubeyran, Pierre, primary, Bellera, Carine, additional, Goyard, Jean, additional, Heitz, Damien, additional, Curé, Hervé, additional, Rousselot, Hubert, additional, Albrand, Gilles, additional, Servent, Véronique, additional, Jean, Olivier Saint, additional, van Praagh, Isabelle, additional, Kurtz, Jean-Emmanuel, additional, Périn, Stéphane, additional, Verhaeghe, Jean-Luc, additional, Terret, Catherine, additional, Desauw, Christophe, additional, Girre, Véronique, additional, Mertens, Cécile, additional, Mathoulin-Pélissier, Simone, additional, and Rainfray, Muriel, additional

Published
2014
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23. Age impacts the pattern of care for elderly patients with rectal cancer

Author

Guillerme, Florence, primary, Clavier, Jean Baptiste, additional, Nehme-Schuster, Hélène, additional, Leroy, Valérie, additional, Heitz, Damien, additional, Schumacher, Catherine, additional, Abdelghani, Méher Ben, additional, Brigand, Cécile, additional, Kurtz, Jean Emmanuel, additional, and Noël, Georges, additional

Published
2013
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25. Frailty: learnings from the SAFEs cohort study and future perspectives for the research

Author

Lang, Pierre-Olivier, additional, Dramé, Moustapha, additional, Mahmoudi, Rachid, additional, Jolly, Damien, additional, Lanièce, Isabelle, additional, Saint-Jean, Olivier, additional, Somme, Dominique, additional, Heitz, Damien, additional, Gauvain, Jean-Bernard, additional, Voisin, Thierry, additional, de Wazières, Benoît, additional, Gonthier, Régis, additional, Jeandel, Claude, additional, Couturier, Pascal, additional, Ankri, Joël, additional, Blanchard, François, additional, and Novella, Jean-Luc, additional

Published
2011
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27. La fragilité du sujet âgé : actualité - perspectives

Author

Dramé, Moustapha, primary, Jovenin, Nicolas, additional, Ankri, Joël, additional, Somme, Dominique, additional, Novella, Jean-Luc, additional, Gauvain, Jean-Bernard, additional, Bige, Vincent, additional, Colvez, Alain, additional, Couturier, Pascal, additional, Heitz, Damien, additional, Voisin, Thierry, additional, De Wazières, Benoît, additional, Gonthier, Régis, additional, Jeandel, Claude, additional, Jolly, Damien, additional, Saint-Jean, Oliver, additional, and Blanchard, François, additional

Published
2004
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29. Loss of independence in Katz's ADL ability in connection with an acute hospitalization: early clinical markers in French older people

Author

Lang, Pierre-Olivier, Meyer, Nicolas, Heitz, Damien, Dramé, Moustapha, Jovenin, Nicolas, Ankri, Joël, Somme, Dominique, Novella, Jean-Luc, Gauvain, Jean-Bernard, Couturier, Pascal, Lanièce, Isabelle, Voisin, Thierry, de Wazières, Benoit, Gonthier, Régis, Jeandel, Claude, Jolly, Damien, Saint-Jean, Olivier, Blanchard, François, Lang, Pierre-Olivier, Meyer, Nicolas, Heitz, Damien, Dramé, Moustapha, Jovenin, Nicolas, Ankri, Joël, Somme, Dominique, Novella, Jean-Luc, Gauvain, Jean-Bernard, Couturier, Pascal, Lanièce, Isabelle, Voisin, Thierry, de Wazières, Benoit, Gonthier, Régis, Jeandel, Claude, Jolly, Damien, Saint-Jean, Olivier, and Blanchard, François

Abstract

Background: The preservation of autonomy and the ability of elderly to carry out the basic activities of daily living, beyond the therapeutic care of any pathologies, appears as one of the main objectives of care during hospitalization. Objectives: To identify early clinical markers associated with the loss of independence in elderly people in short stay hospitals. Methods: Among the 1,306 subjects making up the prospective and multicenter SAFEs cohort study (Sujet Agé Fragile: Évolution et suivi—Frail elderly subjects, evaluation and follow-up), 619 medical inpatients, not disabled at baseline and hospitalized through an emergency department were considered. Data used in a multinomial logistic regression were obtained through a comprehensive geriatric assessment (CGA) conducted in the first week of hospitalization. Dependency levels were assessed at baseline, at inclusion and at 30days using Katz's ADL index. Baseline was defined as the dependence level before occurrence of the event motivating hospitalization. To limit the influence of rehabilitation on the level of dependence, only stays shorter than 30days were considered. Results: About 514 patients were eligible, 15 died and 90 were still hospitalized at end point (n=619). Two-thirds of subjects were women, with a mean age of 83. At day 30 162 patients (31%) were not disabled; 61 (12%) were moderately disabled and 291 severely disabled (57%). No socio-demographic variables seemed to influence the day 30 dependence level. Lack of autonomy (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.2-3.6), walking difficulties (OR=2.7, 95% CI=1.3-5.6), fall risk (OR=2.1, 95% CI=1.3-6.8) and malnutrition risk (OR=2.2, 95% CI=1.5-7.6) were found in multifactorial analysis to be clinical markers for loss of independence. Conclusions: Beyond considerations on the designing of preventive policies targeting the populations at risk that have been identified here, the identification of functional factors (lack of autonomy, wal

30. La fragilité du sujet âgé : actualité - perspectives

Author

Dramé, Moustapha, Jovenin, Nicolas, Ankri, Joël, Somme, Dominique, Novella, Jean-Luc, Gauvain, Jean-Bernard, Bige, Vincent, Colvez, Alain, Couturier, Pascal, Heitz, Damien, Voisin, Thierry, De Wazières, Benoît, Gonthier, Régis, Jeandel, Claude, Jolly, Damien, Saint-Jean, Oliver, Blanchard, François, Dramé, Moustapha, Jovenin, Nicolas, Ankri, Joël, Somme, Dominique, Novella, Jean-Luc, Gauvain, Jean-Bernard, Bige, Vincent, Colvez, Alain, Couturier, Pascal, Heitz, Damien, Voisin, Thierry, De Wazières, Benoît, Gonthier, Régis, Jeandel, Claude, Jolly, Damien, Saint-Jean, Oliver, and Blanchard, François

Abstract

La notion de fragilité est entrée progressivement dans le vocabulaire gériatrique du fait de l’identification d’une sous-population de personnes âgées à plus grand risque de mortalité et d’incapacité. En deux décennies environ, sa définition a progressivement évolué, mais aujourd’hui encore, elle a du mal à faire consensus. Cependant, cliniciens, chercheurs et responsables politiques restent unanimes sur la nécessité de développer des outils de dépistage précoce afin de mettre en place une stratégie de prise en charge adaptée et une démarche préventive cohérente., THE FRAILTY IN THE ELDERLY: ACTUALITY - PROSPECTS The concept of frailty has progressively entered into the geriatric language because of the identification of an elderly people subgroup with high risk of death and disability. In approximately two decades, its definition gradually evolved, but right now, it has trouble making consensus. However, clinicians, researchers and policy makers remain unanimous on the necessity to develop tools for early detection, to set up treatment strategies and consistent preventive steps.

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