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Title: Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer
Author: Feliu, Jaime
Pinto, Alvaro
Basterretxea, Laura
López San Vicente, Borja
Paredero, Irene
Llabrés, Elisenda
Jiménez Munárriz, Beatriz
Antonio, Maite
Losada, Beatriz
Espinosa, Enrique
Gironés, Regina
Custodio, Ana Belén
Muñoz, María del Mar
Díaz Almirón, Mariana
Gómez Mediavilla, Jenifer
Torregrosa, María Dolores
Soler, Gema
Cruz, Patricia
Higuera, Oliver
González Montalvo, Juan Ignacio
Molina Garrido, María José
Keywords: Càncer
Issue Date: 10-Apr-2021
Publisher: MDPI
Abstract: Background: Estimation of life expectancy in older patients is relevant to select the best treatment strategy. We aimed to develop and validate a score to predict early mortality in older patients with cancer. Patients and Methods: A total of 749 patients over 70 years starting new chemotherapy regimens were prospectively included. A prechemotherapy assessment that included sociodemographic variables, tumor/treatment variables, and geriatric assessment variables was performed. Association between these factors and early death was examined using multivariable logistic regression. Score points were assigned to each risk factor. External validation was performed on an independent cohort. Results: In the training cohort, the independent predictors of 6-month mortality were metastatic stage (OR 4.8, 95% CI [2.4-9.6]), ECOG-PS 2 (OR 2.3, 95% CI [1.1-5.2]), ADL ≤ 5 (OR 1.7, 95% CI [1.1-3.5]), serum albumin levels ≤ 3.5 g/dL (OR 3.4, 95% CI [1.7-6.6]), BMI < 23 kg/m2 (OR 2.5, 95% CI [1.3-4.9]), and hemoglobin levels < 11 g/dL (OR 2.4, 95% CI (1.2-4.7)). With these results, we built a prognostic score. The area under the ROC curve was 0.78 (95% CI, 0.73 to 0.84), and in the validation set, it was 0.73 (95% CI: 0.67-0.79). Conclusions: This simple and highly accurate tool can help physicians making decisions in elderly patients with cancer who are planned to initiate chemotherapy treatment.
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It is part of: Journal of Clinical Medicine, 2021, vol. 10, num. 8
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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