Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19)
Abstract Background In older patients with cancer, comorbidities compete with cancer for cause of death. The objectives were to evaluate cancer mortality and factors associated, according to metastatic status. Methods Between 2007 and 2014, patients with cancer aged ≥70 referred for pre‐therapeutic...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6639 |
| _version_ | 1827216919062642688 |
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| author | Déborah Assouan Elena Paillaud Philippe Caillet Amaury Broussier Emmanuelle Kempf Maxime Frelaut Etienne Brain Emmanuelle Lorisson Clelia Chambraud Sylvie Bastuji‐Garin Olivier Hanon Florence Canouï‐Poitrine Marie Laurent Claudia Martinez‐Tapia |
| author_facet | Déborah Assouan Elena Paillaud Philippe Caillet Amaury Broussier Emmanuelle Kempf Maxime Frelaut Etienne Brain Emmanuelle Lorisson Clelia Chambraud Sylvie Bastuji‐Garin Olivier Hanon Florence Canouï‐Poitrine Marie Laurent Claudia Martinez‐Tapia |
| author_sort | Déborah Assouan |
| collection | DOAJ |
| description | Abstract Background In older patients with cancer, comorbidities compete with cancer for cause of death. The objectives were to evaluate cancer mortality and factors associated, according to metastatic status. Methods Between 2007 and 2014, patients with cancer aged ≥70 referred for pre‐therapeutic geriatric assessment (GA) were included through the ELCAPA prospective cohort study. The underlying cause of death was defined according to the International Classification of Diseases, 10th Revision. The World Health Organisation definition was used to categorise the cause of death as cancer versus another disease (e.g. cardiovascular disease, infectious disease, etc.) Competing risk models were used. Results Mean (SD) age of the 1445 included patients was 80.2 (5.8) and 48% were women. Most common tumour sites were colorectal (19%), breast (17%) and urinary (15%); 773 patients (49%) had metastases. After a 34‐month median follow‐up, 706 cancer deaths were observed among 843 deaths. The 6‐month and 3‐year cancer mortality rates (95% CI) were 12% (9–15) and 34% (29–38) for non‐metastatic patients and 43% (39–47) and 79% (75–82) for metastatic patients, respectively. Dependency in activities of daily living and comorbidities were associated with 6‐month and 3‐year cancer mortality in non‐metastatic (adjusted subhazard ratio [aSHR] = 1.68 [0.99–2.85] and 1.69 [1.16–2.45]; and 1.98 [1.08–3.63] and 3.38 [1.47–7.76], respectively) and metastatic patients (aSHR = 2.81 [2.01–3.93] and 2.95 [2.14–4.07]; and 1.63 [1.18–2.25] and 2.06 [1.39–3.05], respectively). Impaired Timed‐Get‐Up‐and‐Go test was associated with 6‐month and 3‐year cancer mortality in metastatic patients (aSHR = 1.5 [1.06–2.12] and 1.38 [1.06–1.81], respectively). Obesity was negatively associated with 3‐year cancer death in non‐metastatic (aSHR = 0.53 [0.29–0.97]) and metastatic patients (aSHR = 0.71 [0.51–1.00]). Conclusions The majority of older adults with cancer referred for pre‐therapeutic GA die from cancer. Geriatric parameters are independently associated with cancer mortality and should be considered for prognosis assessment, decision‐making and care. |
| first_indexed | 2024-03-09T01:32:01Z |
| format | Article |
| id | doaj.art-2713a110f91c4a3d8058b7a20d7bc517 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2025-03-21T15:10:46Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-2713a110f91c4a3d8058b7a20d7bc5172024-06-20T06:46:00ZengWileyCancer Medicine2045-76342023-11-011222209402095210.1002/cam4.6639Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19)Déborah Assouan0Elena Paillaud1Philippe Caillet2Amaury Broussier3Emmanuelle Kempf4Maxime Frelaut5Etienne Brain6Emmanuelle Lorisson7Clelia Chambraud8Sylvie Bastuji‐Garin9Olivier Hanon10Florence Canouï‐Poitrine11Marie Laurent12Claudia Martinez‐Tapia13Univ Paris Est Creteil, INSERM, IMRB Creteil FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceDepartment of Medical Oncology APHP, Henri‐Mondor Hospital Creteil FranceDepartment of Medical Oncology Gustave Roussy Villejuif FranceDepartment of Medical Oncology Institut Curie Saint‐Cloud FranceDepartment of Geriatrics CHIC Creteil FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceAPHP, Broca Hospital Paris FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceUniv Paris Est Creteil, INSERM, IMRB Creteil FranceAbstract Background In older patients with cancer, comorbidities compete with cancer for cause of death. The objectives were to evaluate cancer mortality and factors associated, according to metastatic status. Methods Between 2007 and 2014, patients with cancer aged ≥70 referred for pre‐therapeutic geriatric assessment (GA) were included through the ELCAPA prospective cohort study. The underlying cause of death was defined according to the International Classification of Diseases, 10th Revision. The World Health Organisation definition was used to categorise the cause of death as cancer versus another disease (e.g. cardiovascular disease, infectious disease, etc.) Competing risk models were used. Results Mean (SD) age of the 1445 included patients was 80.2 (5.8) and 48% were women. Most common tumour sites were colorectal (19%), breast (17%) and urinary (15%); 773 patients (49%) had metastases. After a 34‐month median follow‐up, 706 cancer deaths were observed among 843 deaths. The 6‐month and 3‐year cancer mortality rates (95% CI) were 12% (9–15) and 34% (29–38) for non‐metastatic patients and 43% (39–47) and 79% (75–82) for metastatic patients, respectively. Dependency in activities of daily living and comorbidities were associated with 6‐month and 3‐year cancer mortality in non‐metastatic (adjusted subhazard ratio [aSHR] = 1.68 [0.99–2.85] and 1.69 [1.16–2.45]; and 1.98 [1.08–3.63] and 3.38 [1.47–7.76], respectively) and metastatic patients (aSHR = 2.81 [2.01–3.93] and 2.95 [2.14–4.07]; and 1.63 [1.18–2.25] and 2.06 [1.39–3.05], respectively). Impaired Timed‐Get‐Up‐and‐Go test was associated with 6‐month and 3‐year cancer mortality in metastatic patients (aSHR = 1.5 [1.06–2.12] and 1.38 [1.06–1.81], respectively). Obesity was negatively associated with 3‐year cancer death in non‐metastatic (aSHR = 0.53 [0.29–0.97]) and metastatic patients (aSHR = 0.71 [0.51–1.00]). Conclusions The majority of older adults with cancer referred for pre‐therapeutic GA die from cancer. Geriatric parameters are independently associated with cancer mortality and should be considered for prognosis assessment, decision‐making and care.https://doi.org/10.1002/cam4.6639cancercause of deathgeriatric assessment |
| spellingShingle | Déborah Assouan Elena Paillaud Philippe Caillet Amaury Broussier Emmanuelle Kempf Maxime Frelaut Etienne Brain Emmanuelle Lorisson Clelia Chambraud Sylvie Bastuji‐Garin Olivier Hanon Florence Canouï‐Poitrine Marie Laurent Claudia Martinez‐Tapia Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19) Cancer Medicine cancer cause of death geriatric assessment |
| title | Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19) |
| title_full | Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19) |
| title_fullStr | Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19) |
| title_full_unstemmed | Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19) |
| title_short | Cancer mortality and competing causes of death in older adults with cancer: A prospective, multicentre cohort study (ELCAPA‐19) |
| title_sort | cancer mortality and competing causes of death in older adults with cancer a prospective multicentre cohort study elcapa 19 |
| topic | cancer cause of death geriatric assessment |
| url | https://doi.org/10.1002/cam4.6639 |
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