Influence of geriatric oncology consultation on the management of breast cancer in older women: A French population-based study

Aim The objective of the present population-based study was to assess the impact of geriatric oncology consultation on the management of elderly patients with breast cancer and to identify the predictive factors of breast cancer treatment in this population. Methods A total of 206 women aged 75 years and older with breast cancer, diagnosed from January 2007 to December 2009 were included. The independent impact of geriatric oncology consultation on treatment was analyzed using multivariate logistic regression with adjustment for the other predictive factors of treatment. Results Patients who had a geriatric oncology consultation (19.4%) had more comorbidities (Charlson Comorbidity Index ≥1;…

In breast cancer, are treatments and survival the same whatever a patient's age? A population-based study over the period 1998-2009

Aim The present study aimed to describe treatments, relative survival and prognostic factors in breast cancer patients according to age. Methods All women with primary invasive breast cancer, diagnosed from 1998 to 2009 in the department of Cote d'Or, were retrospectively selected. Variations in treatments administered according to age ( 74 years) and period were assessed using Cochran–Armitage trend tests and χ2-tests, respectively. Prognostic factors according to age were estimated using a generalized linear model with a Poisson error structure. Results Overall, 4305 women were included. The oldest women (aged >74 years) were more likely than the youngest women to have comorbidities, adva…

Therapeutic drug monitoring as a tool to optimize 5-FU-based chemotherapy in gastrointestinal cancer patients older than 75 years.

Abstract Aims Most clinical trials exclude elderly people, leading to a limited understanding of the benefit-to-risk ratio in this population. Despite existing data regarding the oncological management of elderly receiving fluorouracil (5-FU)-based regimen, our objective was to investigate 5-FU exposure/toxicity relationship in patients ≥75 years and compare the effectiveness of 5-FU therapeutic drug monitoring between elderly and younger patients. Methods Hundred fifty-four patients (31 of whom are older than 75 years) with gastrointestinal cancers, who were to receive 5-FU–based regimens, were included in our study. At cycle 1 (C1), the 5-FU dose was calculated using patient's body surfac…

PSYCHOBEHAVIORAL DISORDERS, ORTHOSTATIC HYPOTENSION, AND FALLS RELATED TO A PHEOCHROMOCYTOMA IN A VERY ELDERLY SUBJECT: A CASE REPORT

''A case of meningitis due to Achromobacter xylosoxidans denitrificans 60 years after a cranial trauma''

International audience; ''Background: Achromobacter xylosoxidans (AX) is a non-fermentative aerobic Gram-negative bacillus. It is an opportunistic pathogen and the causative agent of various infections. We report an original case of late posttraumatic meningitis due to AX denitrificans. Case Report: An 83-year-old man was hospitalized for acute headache, nausea and vomiting. The emergency brain computer tomography (CT) scan did not reveal any anomaly. In his medical history, there was an auditory injury due to a cranial trauma incurred in a skiing accident 60 years earlier. Cytobiochemical analysis of the cerebrospinal fluid (CSF) revealed increased levels of neutrophils and proteins. The C…

Faut-il réaliser un « Mini-Mental State Examination » chez tout sujet âgé hypertendu ?

Hypertension constitutes a recognized risk factor of vascular dementia but also of Alzheimer-type dementia. Various longitudinal studies showed that midlife blood pressure level is one of the factors conditioning the onset of dementia syndrome in late life. The high risk of dementia is linked to leukoaraiosis, vascular rigidity, microcirculation disorders, oxidative stress, blood pressure fluctuations including orthostatic hypotension and strokes, all of those being associated with hypertension. Numerous clinical trials showed the positive effect of effective treatment of hypertension on the prevention of cognitive disorders and dementias. Thus, screening and early management of dementia an…

Population-based study of breast cancer in older women: prognostic factors of relative survival and predictors of treatment

Abstract Background A large proportion of women with breast cancer (BC) are elderly. However, there is a lack of information regarding BC prognostic factors and care in this population. The aims of this study were to assess the prognostic factors of relative survival (RS) among women with BC aged ≥ 75 years old and to identify the predictive factors of treatments administered to this population. Methods A population-based study was performed using data from the Cote d’Or breast and gynaecological cancer registry. Women aged 75 years and older with primary invasive BC and resident in Cote d’Or at the time of diagnosis made between January 1998 and December 2008 were retrospectively selected.…

Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy

AIM To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer. METHODS This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin (85 mg/m(2) in over 120 min) followed by leucovorin (400 mg/m(2) in over 120 min), with the addition, after 30 min of irinotecan (180 mg/m(2) in over 90 min) then 5 fluorouracil (5FU) (400 mg/m(2) administred intravenous bolus), followed by 5FU (2400 mg/m2 intraveinous infusion over 46 h)…

Management of elderly patients suffering from cancer: Assessment of perceived burden and of quality of life of primary caregivers

International audience; Objective: To evaluate the perceived burden and the quality of life (QoL) at 3 and 6 months of the primary caregiver (PC) of patients aged 70 and over suffering from cancer and the predictors of QoL in this population.Methods: In this prospective observational study, 98 patients aged 70 and older with cancer and 96 PCs were included between 01/06/2014 and 18/03/2015. The Medical Outcomes Study 12-item Short Form Health Survey (SF-12) was used to assess the QoL of PCs and the Zarit Burden Interview (ZBI) was used to measure the perceived burden at 3 and 6 months. The major determinants of QoL were identified using mixed linear models for the dimensions of the SF-12 th…

Décompensation cardiorespiratoire au cours d’une polyarthrite rhumatoïde

Rheumatoid arthritis (RA) may include rare extra-articular manifestations, and particularly cardiopulmonary involvement. We report a 83-year-old woman, with RA, who presented with both pulmonary and heart failures that were related to the RA, resulting from the presence of mediastinal and axillary lymph nodes, and pleural and pericardial effusions. This was confirmed by the dramatic improvement after a specific treatment of RA.

Assessment of the interest of the geriatric oncology consultation among French general practitioners

International audience; OBJECTIVE: We assessed the interest of the geriatric oncology (GO) consultation (GOC) among general practitioners (GPs). MATERIALS AND METHODS: We conducted a survey among GPs whose patients had had a GOC in 2012. A questionnaire was sent to GPs. The 1st part collected GPs' characteristics including medical education in geriatrics and GO, and knowledge of GOC. The following parts concerned the GOC and included the cancer type, GOC report and care plan. RESULTS: One-hundred twenty-six questionnaires corresponding to 94 GPs were collected. Concerning the GPs' characteristics, age range 50-59 (44.7%), men (62.8%) and urban practice (79.8%) were the most represented, 80.…