08549dc0206e00c9239bc2e2da82fc08 pmc_33920250.pdf 4009c90bd680cc7014c52669d20ad61be79d1050 pmc_33920250.pdf a20b05aa9dc90105641f3cc29da4b90e790bffd7295175bc2056d6e16b9a7dd1 pmc_33920250.pdf Title: Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer Subject: 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. Keywords: older patient; early death; prognostic; risk score; geriatric assessment; chemotherapy Author: Jaime Feliu, Alvaro Pinto, Laura Basterretxea, Borja López-San Vicente, Irene Paredero, Elisenda Llabrés, Beatriz Jiménez-Munárriz, Maite Antonio-Rebollo, Beatriz Losada, Enrique Espinosa, Regina Gironés, Ana Belén Custodio, María del Mar Muñoz, Mariana Díaz-Almirón, Jenifer Gómez-Mediavilla, María Dolores Torregrosa, Gema Soler, Patricia Cruz, Oliver Higuera, Juan Ignacio González-Montalvo and María José Molina-Garrido Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Apr 12 12:42:50 2021 CEST ModDate: Mon Apr 12 12:47:52 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1143076 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- IJOHFJ+VnURWPalladioL Type 1 Custom yes yes no 10 0 ZFYLAH+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 TYHEIX+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 JEZNZJ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 ZZLTBA+CMSY10 Type 1 Builtin yes yes no 28 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 40 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 43 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 65 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 69 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 73 0 CAMXTK+EURM10 Type 1 Builtin yes yes no 88 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 95 0 ZYYJXI+EURB10 Type 1 Builtin yes yes no 105 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2021-09-11 03:25:41 CEST RepresentationInformation: pmc_33920250.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2021-05-03 03:48:24 CEST Size: 1143076 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 295 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Predictive Variables Associated with the Risk of Death in the First 6 Months Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Model Prediction of Early Mortality Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Info: Title: Development and Validation of an Early Mortality Risk Score for Older Patients Treated with Chemotherapy for Cancer Author: Jaime Feliu, Alvaro Pinto, Laura Basterretxea, Borja López-San Vicente, Irene Paredero, Elisenda Llabrés, Beatriz Jiménez-Munárriz, Maite Antonio-Rebollo, Beatriz Losada, Enrique Espinosa, Regina Gironés, Ana Belén Custodio, María del Mar Muñoz, Mariana Díaz-Almirón, Jenifer Gómez-Mediavilla, María Dolores Torregrosa, Gema Soler, Patricia Cruz, Oliver Higuera, Juan Ignacio González-Montalvo and María José Molina-Garrido Subject: 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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