The effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer

Background Treating elderly colorectal cancer patients can be challenging. It is very important to carefully weigh the risks and benefits of potential treatments in individual patients. This treatment decision making can be guided by geriatric consultation. Our aim was to assess the effect of a geri...

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Bibliographic Details
Published in:International journal of colorectal disease 2017-11, Vol.32 (11), p.1625-1629
Main Authors: Verweij, N. M., Souwer, E. T. D., Schiphorst, A. H. W., Maas, H. A., Portielje, J. E. A., Pronk, A., van den Bos, F., Hamaker, M. E.
Format: Article
Language:English
Subjects:
Aged
Aged patients
Aged, 80 and over
Cancer patients
Care and treatment
Clinical Decision-Making - methods
Colon cancer
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - pathology
Colorectal Neoplasms - therapy
Decision making
Female
Gastroenterology
Geriatric Assessment - methods
Geriatrics
Hepatology
Hospitals
Humans
Internal Medicine
Male
Malnutrition
Medical screening
Medicine
Medicine & Public Health
Neoplasm Staging
Netherlands - epidemiology
Original Article
Patient Care Planning - organization & administration
Patient Selection
Proctology
Referral and Consultation
Risk Adjustment
Risk Assessment - methods
Surgery
Therapeutic applications
Tumors
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Summary:Background Treating elderly colorectal cancer patients can be challenging. It is very important to carefully weigh the risks and benefits of potential treatments in individual patients. This treatment decision making can be guided by geriatric consultation. Our aim was to assess the effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer. Methods Colorectal cancer patients who were referred for a geriatric consultation between 2013 and 2015 in three Dutch teaching hospitals were included in a prospective database. The outcome of geriatric assessment, non-oncological interventions and geriatricians’ treatment recommendations were evaluated. Results The total number of included referrals was 168. The median age was 81 years (range 60–94). Most patients (71%) had colon cancer and 49% had tumour stage III disease. The reason for geriatric consultation was uncertainty regarding the optimal oncologic treatment in 139 patients (83%). Overall 93% of patients suffered from geriatric impairments; non-oncological interventions that followed after geriatric consultation was mostly aimed at malnutrition. The geriatrician recommended the ‘more intensive treatment’ option in 69% and the ‘less intensive treatment’ option in 31% of which 63% ‘supportive care only’. Conclusion Geriatric consultation can be useful in treatment decision making in elderly patients with colorectal cancer. It may lead to changes in the treatment plan for individual cases and may result in an additional optimisation of patient’s health status prior to treatment.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-017-2883-8