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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ageing implicates a remodeling of our immune system, which is a consequence of the physiological senescence of our cells and tissues coupled with environmental factors and chronic antigen exposure. An immune system that senesces includes more differentiated cells with accumulation of highly differentiated CD4 and CD8 T cells. The pool of naive T cells decreases with the exponential thymic involution induced by age. Differentiated T cells have similar, if not higher, functional capacities but scarce studies are looking at the impact of senescence among specific T cells. After a stimulation, other immune cells (monocytes, dendritic cells and NK) are functionally altered during ageing. It is as if the immune system was more efficient at the basal level, but less efficient after a stimulation in the old compared to young people, likely due to less reserve. Concerning the clinical impact, older people are more prone to certain pathogens and their clinical manifestations differ from the younger people. Severe flu and VZV reactivation are more frequent with an altered cellular response to vaccination. Vaccination failure can have detrimental consequences in people presenting frailty criteria. Old people frailty is majored by their comorbidities and diseases like cancer. Thus, chemotherapies are employed with circumspection in older patients. The use of anti-PD-1/PD-L1 immunotherapies is therefore attractive, because of less side effects with a better response compared to chemotherapy. Old persons inclusion is lacking in current studies and clinical trials. Some subgroups or pooled analyses confirm the gain in response without increased toxicities in older patients but their inclusion criteria differ from the real-life practice. Specific studies focusing on this population are needed because of the increasing cancer incidence with age and the overall ageing of the population.

Management of small renal tumors in older patients is challenging. This study shows that older patients managed by active surveillance will mostly die from other causes than renal cancer, confirming the safety of AS. However, the significant progression rate under active surveillance confirms the need of a careful and vigilant radiological follow-up rather than a simple watchful waiting surveillance. Background: Active surveillance (AS) is a validated option for the treatment of small renal masses (SMRs), especially in older patients. This study investigates the oncologic outcomes and competitive mortality of older patients prospectively assigned to AS. Methods: We conducted a monocentric study on patients =75 years treated between 2011 and 2016 for a SMR. Treatment modalities, biopsy data, survivals (overall, specific, cancer progression) and delayed interventions were analyzed. Results: Overall, 106 patients (median age 80.5 years) were included, of which 41 were managed by AS during a follow-up of 3.4 years [0-7.1]. Seven patients (17%) had a primary biopsy with 3 confirmed renal cell carcinomas. Fourteen patients (34.1%) presented with progression (29.2% local; 4.9% metastatic), 8 (19.5%) requiring delayed interventions (75% ablative therapy and 25% radical nephrectomy). Overall survival (OS) was 68.3% and cancer specific survival was 95.1% during the study period. Competitive mortality was higher (84.6%) than cancer specific mortality (15.4%), P = .001. Conclusion: The growth rate of progression including 4.9% metastatic progression underlines the value of AS compared to simple watchful surveillance in the treatment of SMRs in older patients. Of note, the higher competitive mortality confirm that AS should be preferred to active intervention at the beginning of the management. [ABSTRACT FROM AUTHOR]

Context: Since January 2021, vaccination for COVID-19 has been made possible in France for people aged 75 and over. Patients suffering from a cancer disease are part of a group at risk to develop severe complications to COVID-19. Method: The « Unité de coordination en Onco-Gériatrie région Bretagne » (the Brittany Coordinating Unit in Onco-Geriatrics) has wished to set up an inquest about the acceptability and the tolerance to COVID-19 vaccination by old-aged patients suffering from cancer in the Brittany region. Results: The study has been carried out between May 1, 2021 and August 31, 2021 in 7 Breton centers. 50 patients have been included in the study with an average age of 84 (72-93). At the time of inclusion, 43 patients had already been vaccinated (80% having had 2 injections and 8% only one). Among them, 86% have declared they had had a very good tolerance to the first injection of the vaccine, and 90% to the second injection. 12% of the patients had not been vaccinated. Conclusion: Overall, in our study, old-aged patients suffering from cancer haven't been reluctant to the anti-COVID-19 vaccination and have shown a very good tolerance to these vaccines. However, seen the profile of these patients and the period of inclusion, the number of patients showing a complete vaccinal outline should have been more consistent, indeed even total. [ABSTRACT FROM AUTHOR]

Soft tissue sarcomas (STS) are rare tumors accounting for less than 1% of human cancers. While the highest incidence of sarcomas is observed in elderly, this population is often excluded or poorly represented in clinical trials. The present study reports on clinicopathological presentation, and outcome of sarcoma patients over 90 recorded in the Netsarc.org French national database. NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor board (MDTB), funded by the French National Cancer Institute to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB, second pathological review, and collection of sarcoma patient characteristics and follow‐up are collected in a database Information of patients registered from January 1, 2010, to December 31, 2016, in NETSARC were collected, analyzed and compared to the younger population. Patients with sarcomas aged >90 have almost exclusively sarcomas with complex genomics (92.0% vs. 66.3%), are less frequently metastatic (5.3% vs. 14·7%) at diagnosis, have more often superficial tumors (39.8% vs. 14.7%), as well as limbs and head and neck sites (75.2% vs. 38.7%) (all p < 0.001). Optimal diagnostic procedures and surgery were less frequently performed in patients over 90 (p < 0.001). These patients were less frequently operated in NETSARC centers, as compared to those of younger age groups including aged 80–90. However, local relapse‐free survival, metastatic relapse‐free survival and relapse‐free survival were not significantly different from those of younger patients, in the whole cohort, as well as in the subgroup of operated patients. As expected overall survival was worse in patients over 90 (p < 0.001). Patients over 90 who were not operated had worse overall survival than younger patients (9.9 vs. 27.3 months, p < 0.001). Patients with STS diagnosed after 90 have distinct clinicopathological features, but comparable relapse‐free survival, unless clinical practice guidelines recommendations are not applied. Standard management should be proposed to these patients if oncogeriatric status allows. What's new? While the highest incidence of soft‐tissue sarcoma (STS) is observed in the elderly, this population is often excluded or poorly represented in clinical trials. Therefore, little is known about the characteristics, treatment, and outcomes of STS in these patients. In this study, the authors analyzed numerous clinical characteristics of patients with sarcoma diagnosed at age 91 or older. They conclude that standard STS management and clinical practice guidelines should be followed for these patients if possible. [ABSTRACT FROM AUTHOR]

Sarah Schroyen,1 Stéphane Adam,1 Guy Jerusalem,2,3 Pierre Missotten1 1University of Liège, Psychology of Aging Unit, 2University of Liège, Laboratory of Medical Oncology, 3CHU Sart Tilman Liege, Department of Medical Oncology, Liège, Belgium Abstract: Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism). These stigmas can result in deleterious consequences for elderly people’s mental and physical health in “normal” aging. What, then, is the impact in a pathological context, such as oncology? Moreover, health care professionals’ attitudes can be tainted with ageism, thus leading to undesirable consequences for patients. To counter these stigmas, we can apply some possible interventions emerging from research on normal aging and from social psychology, such as intergenerational contact, activation of positive stereotypes, self-affirmation, and so on; these tools can improve opinions of aging among the elderly people themselves, as well as health care professionals, thus affecting patients’ mental and physical health. Keywords: oncogeriatry, clinical approaches, stigmatization, ageism

There are an increasing number of elderly people diagnosed with cancer who attend consultations for Medical Oncology. The aging process and the high variability in the geriatric population mean that is due to consider the physiological age of the elderly, not the biological age. For this reason, it is necessary to make a brief, specific and individualized assessment to every older patient diagnosed with cancer who come to our consultation. Comprehensive Geriatric Assessment (CGA) is the key tool to assess properly and to promote decision making in the elderly diagnosed with cancer. Since the CGA is high time-consuming in a daily practice, they have been developed different screening tools to shorten patient care. These screening tools let the selection of those patients that have to undergo CGA. There have been various models of CGA in Oncogeriatry. There is not unanimity; and they have been developed different tools for screening of frailty in the elderly cancer, the most known being the questionnaire VES-13 and G-8 questionnaire. In this manuscript we have made a review about the scientific evidence regarding the care and assessment of older patients with cancer and the different tools to make a final decision in this group of the population. These data reflect the need of Oncogeriatry as a way to provide an optimal global attention to older patients with cancer. [ABSTRACT FROM AUTHOR]

Cancer is a major health problem that is widespread in elderly people. Paradoxically, older people suffering from cancer are often excluded from clinical trials and are undertreated when compared to younger patients. One explanation for these observations is age stigma (ie, stereotypes linked to age, and thus ageism). These stigmas can result in deleterious consequences for elderly people's mental and physical health in "normal" aging. What, then, is the impact in a pathological context, such as oncology? Moreover, health care professionals' attitudes can be tainted with ageism, thus leading to undesirable consequences for patients. To counter these stigmas, we can apply some possible interventions emerging from research on normal aging and from social psychology, such as intergenerational contact, activation of positive stereotypes, self-affirmation, and so on; these tools can improve opinions of aging among the elderly people themselves, as well as health care professionals, thus affecting patients' mental and physical health. [ABSTRACT FROM AUTHOR]

Copyright of Colon & Rectum is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Strahlentherapie und Onkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Digestive cancers are frequent in elderly patients. However, there are few specific studies on treatment in elderly patients. Selection of the patient is basic to apply the treatment validated in younger patient. Adaptation of the treatment to each case should be done in a multidisciplinary team with a geriatrician. [ABSTRACT FROM AUTHOR]

The care of colorectal cancer in elderly is a growing topic. Significant improvement has been realized in the care available for these patients. A lot of studies are still needed to better define accurate treatment for these patients. [ABSTRACT FROM AUTHOR]

Copyright of Colon & Rectum is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: In oncogeriatric patients, severe malnutrition is associated with increased morbidity and mortality, nosocomial infections, radiotherapy or chemotherapy toxicities, and decreased of quality of life. Therefore, systematic screening and care of malnutrition is mandatory, in accordance with the French guidelines in 2007. Now, dietary couselling should be purposed systematically in malnourish patients and when radiotherapy or radiochemotherapy are considered. Oral supplementation by specific diet (immune-enhancing diets) should be used with cautions, and actually, reserved only in digestive neoplasms and surgery. In cases of severely malnourished patients or if dietary counselling suffers a setback, enteral nutrition should be recommended. In radiotherapy or chemotherapy, used parenteral nutrition is associated with an increase in infectious complications. Artificial nutrition should not be used when Karnofski index is lesser than 50% (or performance status greater than 2) and prognosis lesser at three months. [Copyright &y& Elsevier]

Simple Summary: Most oncology patients today are ≥65 years, so we should include in our daily practice tools that facilitate the therapeutic approach for elderly patients. Care overburden makes it difficult to perform comprehensive geriatric assessments (CGAs). The aim of our prospective study was to analyze if frailty screening questionnaires, such as G8 or Charlson, could lead to rapid decision making about treatment change in a radiation oncology service. In a homogeneous population of 161 patients, with a median age of 75 years, we found that 28.7% were frail according to the G8 test, while the estimated survival at 10 years was 2.25% based on the Charlson test. The therapeutic modification increased to 21% after frailty analysis, and the radiotherapy prescribed was 5.8 times more likely to be modified in frail patients. Thus, we postulate that the frailty screening test, easier to integrate into clinical practice, is a reliable and efficient aid for optimal approach. Background: Care overburden makes it difficult to perform comprehensive geriatric assessments (CGAs) in oncology settings. We analyzed if screening tools modified radiotherapy in oncogeriatric patients. Methods: Patients ≥ 65 years, irradiated between December 2020 and March 2021 at the Hospital Provincial de Castellón, completed the frailty G8 and estimated survival Charlson questionnaires. The cohort was stratified between G8 score ≤ 14 (fragile) or >14 (robust); the cutoff point for the Charlson index was established at five. Results: Of 161 patients; 69.4% were male, the median age was 75 years (range 65–91), and the prevailing performance status (PS) was 0–1 (83.1%). Overall, 28.7% of the cohort were frail based on G8 scores, while the estimated survival at 10 years was 2.25% based on the Charlson test. The treatment administered changed up to 21% after frailty analysis. The therapies prescribed were 5.8 times more likely to be modified in frail patients based on the G8 test. In addition, patients ≥ 85 years (p = 0.01), a PS ≥ 2 (p = 0.008), and limited mobility (p = 0.024) were also associated with a potential change. Conclusions: CGAs remain the optimal assessment tool in oncogeriatry. However, we found that the G8 fragility screening test, which is easier to integrate into patient consultations, is a reliable and efficient aid to rapid decision making. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to assess prevalence of geriatric assessment (GA) in patients over 75years with nonmetastatic invasive bladder cancer (MIBC)., Material and Methods: We performed a retrospective study between 2000 and 2015. We assessed comobidity by Charlson score and ASA score, geriatric assessement (GA) and treatments., Results: One hundred and twenty one patients were inclued. Median age was 81 (73-95) at diagnosis. Thirty nine patients (32%) were evaluated by GA, G8 screening tool was performed in 16% of patients. Patients without GA were older (82 vs. 81years) and had less comorbidities (Charlson≥2 à 61% vs. 69%). Seventy-four percent of patients received a curarive therapy: 60% were treated by RC, 9% by chemoradiotherapy, 26% received palliative therapy and 15% were only in observation., Conclusion: Patients with MIBC over 75years were less evaluated and less treated. Patients in pallative care received mostly observation. Although practices have improved, GA was underused. Care of these patients needs standardization in order to adapt therapeutic to their comorbidities and to treat them with curative intent., Level of Proof: 4., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Summary: Objective: The purpose of this article is to illustrate the use of radiofrequency and laser ablation in head and neck oncology and to describe the management of a case of laryngeal chondrosarcoma in a 90-year-old patient. Case report: A 90-year-old man, WHO performance status 3, with low-grade laryngeal chondrosarcoma was seen in the outpatients department at the end of 2008 for assessment of dysphonia. Total laryngectomy was considered to be too invasive and was consequently excluded. The patient was initially tracheotomized under local anaesthesia to relieve dyspnoea and was subsequently managed symptomatically by radiofrequency and laser ablation to ensure laryngeal disobstruction, allowing the patient to be extubated followed by speech therapy and oral feeding rehabilitation. Discussion/conclusion: This patient received symptomatic palliative treatment with a combination of radiofrequency and laser. Radiofrequency ablation can be applied in head and neck oncology as an alternative treatment to surgery allowing improvement of quality of life and survival. [Copyright &y& Elsevier]

Being aging is a gradual process characterized by the progressive loss of functionality, with it comes various deficiencies and physiological changes. It is known that in adulthood, there is a predominance of Non- -Communicable Chronic Diseases (DCNT), which increases as the number of years of each person increases, with cancer being one of the most incident diseases. It is the role of the study of oncogeriatria, a multidisciplinary approach in the elderly with cancer. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is the leading type of cancer among men in more developed countries. Incidence trends and survival rates could differ by age groups considering potential differences in the frequency of PSA testing, types of cancers and medical management. Our objective was to compare incidence trends and survival rates of prostate cancer between men aged ≥75 and 60-74 years., Method: We analyzed data from a population-based cancer registry in Isère, France. All men aged ≥60 years diagnosed with an incident prostate cancer during the 1991-2013 period were included. Incidence and mortality rates were computed as well as net survival rates., Results: In 2013, observed incidence rates were 557.6 and 568.7 per 100,000 for men aged 60-74 and ≥75, respectively, with high grades cancers more frequent among elderly men. The incidence and mortality trends among men aged ≥75 included a period of stability followed by a decreasing trend from 2003, whereas a peak of incidence was observed in 2005 for men aged 60-74. For both age groups, net survival rates increased with period of diagnosis and 8-year net survival remained higher than 70% for cases diagnosed in the 2000-2004 period. Lower survival rate of 51% (95%CI: 42%; 60%) was observed for high grades cancers diagnosed among men aged 75-84 in 2000-2004., Conclusion: The epidemiology of prostate cancers among men aged ≥75 include a decrease of incidence and mortality rates from 2003, an important proportion of high grade cancers and a relatively good prognosis except for high grade cancers., (Copyright © 2018 Elsevier Ltd. All rights reserved.)