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European Archives of Oto-Rhino-Laryngology

Open Access 23-04-2024 | Geriatric Assessment | Head and Neck

Evaluation of a new two-step frailty assessment of head and neck patients in a prospective cohort

Authors: Beniamino Vincenzoni Padovan, M. A. J. Bijl, J. A. Langendijk, H. P. van der Laan, B. A. C. Van Dijk, S. Festen, G. B. Halmos

Published in: European Archives of Oto-Rhino-Laryngology

Abstract

Purpose

Assessing frailty, in head and neck cancer (HNC) patients is key when choosing appropriate treatment. Optimal screening is challenging, as it should be feasible and should avoid over-referral for comprehensive geriatric assessment (CGA) This study aims to evaluate the association between geriatric assessment using a new two-step care pathway, referral to geriatrician and adverse outcomes.

Methods

This institutional retrospective analysis on a prospective cohort analysed the multimodal geriatric assessment (GA) of newly diagnosed HNC patients. Uni- and multivariable logistic regression was performed to study the association between the screening tests, and referral to the geriatrician for complete geriatric screening, and adverse outcomes.

Results

This study included 539 patients, of whom 276 were screened. Patients who underwent the GA, were significantly older and more often had advanced tumour stages compared to non-screened patients. Referral to the geriatrician was done for 30.8% of patients. Of the 130 patients who underwent surgery, 26/130 (20%) experienced clinically relevant postoperative complications. Of the 184 patients who underwent (radio)chemotherapy, 50/184 (27.2%) had clinically relevant treatment-related toxicity. Age, treatment intensity, polypharmacy and cognitive deficits, were independently associated with referral to geriatrician. A medium to high risk of malnutrition was independently associated with acute radiation induced toxicity and adverse outcomes in general.

Conclusion

The current study showed a 30.8% referral rate for CGA by a geriatrician. Age, treatment intensity, cognitive deficits and polypharmacy were associated with higher rates of referral. Furthermore, nutritional status was found to be an important negative factor for adverse treatment outcomes, that requires attention.

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Title: Evaluation of a new two-step frailty assessment of head and neck patients in a prospective cohort
Authors: Beniamino Vincenzoni Padovan
M. A. J. Bijl
J. A. Langendijk
H. P. van der Laan
B. A. C. Van Dijk
S. Festen
G. B. Halmos
Publication date: 23-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Geriatric Assessment
Malnutrition
Published in: European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08651-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Evaluation of a new two-step frailty assessment of head and neck patients in a prospective cohort

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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