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4 results on '"N Anfasi"'

1. Évaluation gériatrique en oncologie : pour quels patients ?

Author

Evelyne Liuu, H Curé, N Anfasi, Elena Paillaud, Pierre Soubeyran, Philippe Caillet, Florence Canoui-Poitrine, F. Pamoukdjian, sous l’égide de la Société francophone d’oncogériatrie, and L. De Decker

Subjects
Older person, medicine.medical_specialty, business.industry, Gastroenterology, Vulnerability, Cancer, Geriatric assessment, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Geriatric oncology, Anticancer treatment, 030220 oncology & carcinogenesis, Internal Medicine, medicine, 030212 general & internal medicine, Intensive care medicine, business, Risk assessment, Mass screening
Abstract

Scientific societies recommend the implementation of a comprehensive geriatric assessment (CGA) in cancer patients aged 70 and older. The EGA is an interdisciplinary multidimensional diagnostic process seeking to assess the frail older person in order to develop a coordinated plan of treatment and long-term follow-up. Identification of comorbidities and age-induced physiological changes that may increase the risk of anticancer treatment toxicities is essential to better assess the risk-benefit ratio in elderly cancer patients. The systematic implementation of a CGA for each patient is difficult to perform in daily practice. Therefore, it is recommended to screen vulnerable patients who will benefit from a complete CGA. Our work presents the vulnerability screening tools validated by at least two independent studies in a cancer elderly population setting. Among seven screening tools, the G8 and the VES13 are the most effective, and have been validated specifically in older population with cancer. The G8 is recommended by scientific societies and the French National Cancer Institute (INCa) because of its easy implementation in daily clinical practice, its high sensitivity and fair specificity. Although studies are underway to improve its performance, the G8 is currently the simplest tool to routinely identify older cancer patients who should have a complete assessment in geriatric oncology.

Published
2016
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2. [Comprehensive geriatric assessment (CGA) in elderly with cancer: For whom?]

Author

E, Liuu, P, Caillet, H, Curé, N, Anfasi, L, De Decker, F, Pamoukdjian, F, Canouï-Poitrine, P, Soubeyran, and E, Paillaud

Subjects
Neoplasms, Humans, Mass Screening, Reproducibility of Results, Geriatric Assessment, Risk Assessment, Sensitivity and Specificity, Aged
Abstract

Scientific societies recommend the implementation of a comprehensive geriatric assessment (CGA) in cancer patients aged 70 and older. The EGA is an interdisciplinary multidimensional diagnostic process seeking to assess the frail older person in order to develop a coordinated plan of treatment and long-term follow-up. Identification of comorbidities and age-induced physiological changes that may increase the risk of anticancer treatment toxicities is essential to better assess the risk-benefit ratio in elderly cancer patients. The systematic implementation of a CGA for each patient is difficult to perform in daily practice. Therefore, it is recommended to screen vulnerable patients who will benefit from a complete CGA. Our work presents the vulnerability screening tools validated by at least two independent studies in a cancer elderly population setting. Among seven screening tools, the G8 and the VES13 are the most effective, and have been validated specifically in older population with cancer. The G8 is recommended by scientific societies and the French National Cancer Institute (INCa) because of its easy implementation in daily clinical practice, its high sensitivity and fair specificity. Although studies are underway to improve its performance, the G8 is currently the simplest tool to routinely identify older cancer patients who should have a complete assessment in geriatric oncology.

Published
2015

3. Prognosis value of the g-8 for early death in older patients with cancer: The elcapa cohort study

Author

Elena Paillaud, Christophe Tournigand, N Anfasi, Marie Laurent, Florence Canoui-Poitrine, Sylvie Bastuji-Garin, Philippe Caillet, Etienne Audureau, Evelyne Liuu, and Esther Guery

Subjects
medicine.medical_specialty, Oncology, Older patients, business.industry, Internal medicine, medicine, Cancer, Early death, Geriatrics and Gerontology, medicine.disease, business, Value (mathematics), Cohort study
Published
2014
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4. Preferences about information and decision-making among older patients with and without cancer.

Author

Paillaud E, Canoui-Poitrine F, Varnier G, Anfasi-Ebadi N, Guery E, Saint-Jean O, Gisselbrecht M, Aparicio T, Bastuji-Garin S, Laurent M, and Caillet P

Subjects
Age Factors, Aged, Aged, 80 and over, Chi-Square Distribution, Cross-Sectional Studies, Female, Hospitals, Teaching, Humans, Logistic Models, Male, Mental Status and Dementia Tests, Multivariate Analysis, Odds Ratio, Paris, Surveys and Questionnaires, Access to Information, Choice Behavior, Health Knowledge, Attitudes, Practice, Neoplasms psychology, Patient Care Planning, Patient Preference, Proxy, Third-Party Consent
Abstract

Background: information of older patients with cancer is crucial to ensure optimal care., Objectives: to compare older patients with and without cancer regarding their preferences about medical information, decision-making and surrogate designation., Design: an intention-to-act questionnaire was completed by patients ≥70 y enroled in the ELderly CAncer PAtients cohort between January and June 2013 and by patients in the same age group enroled in a cross-sectional survey conducted in 2005 in acute geriatric wards., Setting: Henri-Mondor Teaching Hospital in the Paris conurbation, France., Results: the group with cancer had 133 patients [mean age, 79.6 ± 6.5 y; 54.9% women]. The main tumour sites were colorectal [24.1%], breast [23.3%] and prostate [15.8%]; 34.8% had metastases. All these patients wanted full information, 74.2% wanted to participate in decisions about their care, 87.2% would designate a family member to serve as a surrogate in life-threatening situations and 15% had already designated a surrogate. Compared to patients without cancer, those with cancer more often wanted to receive information in a life-threatening situation [93.6% versus 79.2%; P < 0.001]. Factors independently associated with patients wanting their informed consent to be obtained for all interventions were having children [adjusted odds ratio (aOR), 2.13; 95% confidence interval, 1.24; 3.66; P = 0.006], higher Mini Mental State Examination score [aORper point, 1.09; 1.02; 1.17], younger age in the group without cancer [aOR>82 y vs. ≤82 y, 0.50; 0.29-0.88] and being cancer-free [≤82 y, aOR, 0.30; 0.14-0.63; >82 y, aOR, 0.41; 0.17-0.97]., Conclusion: older patients with cancer expressed a strong preference for receiving information and participating in decisions about their care., (© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com)

Published
2017
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