Journal of geriatric oncology最新文献

{"title":"Risk factors for venous thromboembolism in older patients with malignant solid tumors: A systematic review","authors":"Xue Hu ,&nbsp;Dan Zhou ,&nbsp;Lin Su ,&nbsp;Wenwu Cheng ,&nbsp;Li Mo","doi":"10.1016/j.jgo.2026.102894","DOIUrl":"10.1016/j.jgo.2026.102894","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to systematically analyze the risk factors for venous thromboembolism (VTE) in patients aged ≥60 years with malignant solid tumors to facilitate targeted prevention.</div></div><div><h3>Materials and methods</h3><div>We searched Ovid MEDLINE, EMBASE, SCIE, and SCOPUS databases for articles from inception to April 24, 2024. Article quality was assessed via the Newcastle-Ottawa Scale, with data extracted independently by two reviewers and thematically categorized.</div></div><div><h3>Results</h3><div>Sixteen studies (<em>n</em> = 964,290 patients) were included. VTE incidence varied significantly by cancer type, ranging from 1.2% (prostate cancer) to 20.3% (colorectal cancer). Twenty-nine distinct risk factors were identified across five domains: (1) Treatment-related: chemotherapy (significant risk factor in 8/9 studies), radiotherapy, and targeted therapy. (2) Disease-related: advanced tumor stage (reported in 56% of studies) and high-risk cancer types (pancreatic and colorectal). (3) Comorbidity-related: cardiovascular disease (44% of studies), kidney disease, and a VTE history (strongest predictor, hazard ratio = 5.4–20.1). (4) Sociodemographic: Black race (highest risk), female sex (increased risk for colorectal/renal cancer), and older age. (5) Laboratory: elevated D-dimer level (≥600 μg/L) and low partial pressure of oxygen (&lt;75 mmHg). An “age paradox” was observed: while age is a risk factor, the relative contribution of cancer to VTE diminished with age, and the observed VTE incidence decreased in very old individuals (≥85 years), likely due to competing mortality.</div></div><div><h3>Discussion</h3><div>The risk of VTE in older patients with solid tumors is multidimensional. Current risk models are inadequate. Future tools must integrate tumor characteristics, treatment exposures, geriatric-specific factors (comorbidities, frailty), and bleeding risk to optimize personalized thromboprophylaxis.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102894"},"PeriodicalIF":2.7,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of frailty, functional status & comorbidities in older adults with multiple myeloma undergoing high dose therapy & autologous stem cell transplant","authors":"Nadine Abdallah ,&nbsp;Ashlyn O’Leary ,&nbsp;Cynthia M. Schmidt ,&nbsp;Sikander Ailawadhi ,&nbsp;Hira Mian ,&nbsp;Ashley Rosko ,&nbsp;Tanya M. Wildes","doi":"10.1016/j.jgo.2025.102846","DOIUrl":"10.1016/j.jgo.2025.102846","url":null,"abstract":"<div><h3>Introduction</h3><div>Improvements in supportive care strategies and growing evidence for benefit have led to increased use of autologous stem cell transplant (ASCT) in older patients with multiple myeloma (MM). However, the lack of standardized criteria for transplant eligibility often leaves the decision to the physician's clinical judgment. The roles of frailty/geriatric assessment tools, functional status, and comorbidity in selecting candidates and predicting transplant outcomes in older patients with MM remain uncertain. The purpose of this systematic review was to examine the measures of frailty, functional status, and comorbidity reported for older patients with MM who underwent ASCT and to evaluate their association with outcomes.</div></div><div><h3>Materials and methods</h3><div>On April 11, 2024, MEDLINE, EMBASE, and the Cochrane Library were searched for articles that included older adults (&gt;60 years) with MM addressing the use of ASCT or ASCT eligibility/ineligibility. We included retrospective and prospective studies that included (1) at least one measure of functional status and/or comorbidities and (2) at least one transplant-related outcome (response rate, transplant-related mortality).</div></div><div><h3>Results</h3><div>Twenty-five studies were included, four prospective and 21 retrospective. Of these, four studies utilized the International Myeloma Working Group (IMWG) frailty index, with some including frail patients. In one study utilizing a comprehensive geriatric assessment, &gt;50 % of older adults who were considered transplant-eligible reported dependence on ≥1 Instrumental Activities of Daily Living (IADL), severe limitations in vigorous activities, and/or self-reported weight loss. Eighteen studies reported a measure of functional status, most commonly Eastern Cooperative Oncology Group Performance Status; 19 studies reported a comorbidity measure, most commonly Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI). The comorbidity scores were generally low in patients who underwent ASCT (&lt;3). The 100-day treatment-related mortality ranged from 0 % to 6 %, with overall response rates were generally high across studies.</div></div><div><h3>Discussion</h3><div>There is wide variability in the tools used to assess characteristics of older adults who underwent ASCT across studies. The optimal tool for selecting older ASCT candidates remains undefined, but it is likely that no single measure can adequately capture overall health status. Prospective studies incorporating a multidimensional assessment are necessary to better define transplant eligibility in this population.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102846"},"PeriodicalIF":2.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric prehabilitation prior to surgery for kidney tumors: Study protocol for Pre-KiT - A randomized controlled trial","authors":"Marie Juul-Haslund ,&nbsp;Cecilia M. Lund ,&nbsp;Troels G. Dolin ,&nbsp;Katrine Schou-Jensen ,&nbsp;Peter B. Østergren ,&nbsp;Anders Vinther ,&nbsp;Frederik F. Thomsen ,&nbsp;Mikkel Fode","doi":"10.1016/j.jgo.2026.102893","DOIUrl":"10.1016/j.jgo.2026.102893","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma (RCC) primarily affects older adults who often present with frailty, increasing their risk of surgical complications and delayed recovery. Prehabilitation, incorporating exercise, nutrition, and psychological support, may improve postoperative outcomes. However, no studies have investigated prehabilitation prior to surgery for RCC. The aim is to assess whether a one-month multimodal prehabilitation program including geriatric interventions improves recovery in patients with frailty undergoing surgery for localized RCC ≤ 7 cm.</div></div><div><h3>Materials and methods</h3><div>60 patients, aged ≥65, with a Clinical Frailty Scale (CFS) score of 3–6 are randomized 1:1 to standard care or prehabilitation involving home-based exercise, geriatric assessment with tailored interventions, and smoking cessation support. The primary outcome is change in Quality of Recovery-15 (QoR-15) 21 days postoperatively. Secondary outcomes include changes in QoR-15, health-related quality of life (EQ-5D-5L) and physical performance (30-s chair-stand test, handgrip strength) assessed preoperatively, 1, 21 and 90 days postoperatively. Postoperative complications will be evaluated using the Clavien-Dindo classification, alongside a cost-effectiveness analysis. Long-term outcomes include 1- and 5-year recurrence-free, cancer-specific, and overall survival.</div></div><div><h3>Discussion</h3><div>Pre-KiT explores if a pragmatic geriatric prehabilitation strategy is effective and feasible for older frail patients with RCC. The intervention is designed for easy implementation in clinical practice: administered by a single healthcare professional, requiring only one additional hospital visit, and consists of home-based exercises. This low-resource approach also aims to minimize financial costs, which is of importance for implementation possibilities. If successful, it could improve standard care and outcomes after surgery.</div><div><em>Trial registration</em>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID: <span><span>NCT06745609</span><svg><path></path></svg></span>. Prospectively registered December 12th, 2024.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102893"},"PeriodicalIF":2.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the Editor: Geriatric assessment and sarcopenia in pancreatic cancer: Toward personalized treatment beyond chronological age","authors":"Giovanni Trovato ,&nbsp;Lisa Salvatore ,&nbsp;Giampaolo Tortora","doi":"10.1016/j.jgo.2026.102890","DOIUrl":"10.1016/j.jgo.2026.102890","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102890"},"PeriodicalIF":2.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A literature review on hypothalamic–pituitary–adrenal (HPA) axis dysregulation in older adults with cancer: A missing link in predicting treatment toxicity?","authors":"Len De Nys","doi":"10.1016/j.jgo.2026.102854","DOIUrl":"10.1016/j.jgo.2026.102854","url":null,"abstract":"<div><div>Older adults with cancer face disproportionately high rates of severe treatment-related toxicities, yet current prediction tools rarely incorporate biomarkers that capture physiological resilience. The hypothalamic–pituitary–adrenal (HPA) axis—central to stress adaptation, immune regulation, and tissue repair—undergoes pronounced age-related alterations, including elevated basal cortisol, reduced dehydroepiandrosterone (DHEA) and its sulphate form DHEAS, and an increased cortisol:DHEA(S) ratio. These changes may impair immune function, delay recovery, and exacerbate vulnerability to treatment toxicity. This narrative review synthesizes mechanistic and clinical evidence linking HPA-axis dysregulation to treatment tolerance in geriatric oncology. Common patterns include blunted diurnal cortisol slopes, elevated evening cortisol, and low DHEA(S), which are associated with fatigue, functional decline, and reduced survival across cancer types. However, their predictive value for acute treatment toxicities remains underexplored due to methodological heterogeneity, lack of age-specific reference ranges, and absence from existing geriatric toxicity models. This review proposes a translational roadmap that prioritizes (1) standardization of salivary cortisol/DHEA(S) protocols; (2) prospective, age-stratified validation studies using standardized toxicity endpoints; (3) interventional testing of behavioral or pharmacological strategies to modulate HPA function; and (4) integration into oncology workflows and electronic decision-support tools. Incorporating endocrine biomarkers into risk prediction could refine treatment stratification, enable targeted supportive care, and ultimately improve outcomes for older patients with cancer.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102854"},"PeriodicalIF":2.7,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What nutritional interventions can effectively treat sarcopenia in older adults with cancer? A systematic review","authors":"Megan Pattwell ,&nbsp;Michelle Gibbs ,&nbsp;Colm Mac Eochagáin ,&nbsp;Emma Crewe ,&nbsp;Anne Barrell ,&nbsp;Erin Stella Sullivan ,&nbsp;Hannah Furness ,&nbsp;Ione de Brito-Ashurst ,&nbsp;Susanne Cruickshank ,&nbsp;Nicolò Matteo Luca Battisti","doi":"10.1016/j.jgo.2026.102850","DOIUrl":"10.1016/j.jgo.2026.102850","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer primarily affects older adults, with a significant proportion also experiencing sarcopenia which is associated with poor clinical outcomes. In older adults with cancer, sarcopenia is not only age-related but also exacerbated by disease processes, inflammation, and the catabolic effects of treatments such as chemotherapy and radiotherapy. Its presence is linked to increased treatment toxicity, longer hospitalisations, reduced physical function, and poorer survival rates. However, diagnosing sarcopenia remains challenging due to inconsistent criteria and limited access to diagnostic tools. Emerging evidence suggests that nutritional interventions may help prevent or reverse sarcopenia. This review aims to evaluate the effectiveness of nutritional interventions in managing sarcopenia in older adults with cancer.</div></div><div><h3>Materials and methods</h3><div>A systematic review was conducted using the PICO framework, targeting studies involving patients aged 65 and older with cancer and confirmed or likely sarcopenia. A total of 1439 studies were retrieved from databases and screened using Rayyan. Data extraction focused on outcomes related to body composition, physical performance, and nutritional intake. Risk of bias was assessed using RoB2, ROBINS-I, and ROBINS-E tools. Due to heterogeneity in study designs and outcome measures, a narrative synthesis was performed using SWiM guidelines. Studies were grouped by design and intervention type, and the GRADE approach was applied to assess evidence certainty.</div></div><div><h3>Results</h3><div>Nine studies (2016–2024) met the inclusion criteria. Interventions included dietary supplements, nutritional counselling, enteral feeding, and multimodal strategies. Most studies showed improvements in sarcopenia-related outcomes. Protein supplementation notably improved lean body mass and skeletal muscle index in some randomised control trials (RCTs). Observational studies found associations between certain dietary patterns—such as high fish and fat intake—and reduced sarcopenia risk.</div></div><div><h3>Discussion</h3><div>Nutritional interventions show promise in managing sarcopenia among older adults with cancer. However, further large-scale, standardised research is needed. Meanwhile, promoting good nutrition and physical activity remains essential.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102850"},"PeriodicalIF":2.7,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recalibrating the Hester Davis Scale for fall risk in patients with breast cancer","authors":"Asmaa Namoos ,&nbsp;Nicholas Thomson ,&nbsp;Rana Ramadan ,&nbsp;Tamas Gal","doi":"10.1016/j.jgo.2026.102856","DOIUrl":"10.1016/j.jgo.2026.102856","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102856"},"PeriodicalIF":2.7,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival benefit from evidence-based treatment for rectal cancer among older people – Analysis of SEER-medicare","authors":"Uma R. Phatak ,&nbsp;Yong Shan ,&nbsp;Yong-Fang Kuo","doi":"10.1016/j.jgo.2026.102851","DOIUrl":"10.1016/j.jgo.2026.102851","url":null,"abstract":"<div><h3>Introduction</h3><div>The treatment of stage III rectal cancer (RC) is complex and requires a multidisciplinary approach. Evidence-based guidelines (EBG) exist for the treatment of RC. We aimed to determine adherence to EBG in the treatment of stage III RC and the impact on survival in older adults.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective study of patients within the Surveillance, Epidemiology, and End Results program (SEER). We included adults with stage III RC between 2007 and 2018 with one pathologically confirmed primary tumor. We defined guideline-based care as receipt of: chemoradiation within 6 months of date of diagnosis; surgery within 6 months of completion of chemoradiation; and chemotherapy after surgery. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method. Multivariable Cox regression was performed to determine factors associated with survival.</div></div><div><h3>Results</h3><div>We identified 3962 patients, and 1945 (49.1%) were female. There were 1707 (43.1%) with a Charlson Comorbidity Index of zero. Of the total, 994 (25.1%) received all guideline-based treatments. Factors associated with lack of guideline-based care included age, comorbidities, income, and geographic location. Guideline-based care was associated with increased OS (HR: 0.55, 95% CI: 0.49–0.60) and CSS (HR: 0.59, 95% CI: 0.48–0.73).</div></div><div><h3>Discussion</h3><div>Although 43.1% of the cohort had a comorbidity index of zero, only 25.1% received all guideline-based treatments. Deviation from guideline-based care had a significant impact on OS. Our data show that more efforts can be made to recommend multimodal RC treatment among older adults.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102851"},"PeriodicalIF":2.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncogeriatric assessment: Expert consensus recommendations in Chile","authors":"Rocío Quilodrán Loyola ,&nbsp;Gabriel Martínez Fuentes ,&nbsp;Isidora Jiménez Álvarez ,&nbsp;Evangelina Röling ,&nbsp;Gonzalo Navarrete Hernández","doi":"10.1016/j.jgo.2026.102847","DOIUrl":"10.1016/j.jgo.2026.102847","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102847"},"PeriodicalIF":2.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity cluster trajectories across the care continuum in older women with breast cancer initiating adjuvant endocrine therapy","authors":"Sola Han ,&nbsp;Hyejoong M. Lee ,&nbsp;Chanhyun Park","doi":"10.1016/j.jgo.2026.102852","DOIUrl":"10.1016/j.jgo.2026.102852","url":null,"abstract":"<div><h3>Introduction</h3><div>With the growing population of older breast cancer survivors, understanding how chronic comorbidities evolve across treatment and toward the end-of-life (EOL) is increasingly important. We aimed to characterize temporal and EOL patterns of comorbidity clusters before and after adjuvant endocrine therapy (AET) among women aged 66–79 years and ≥ 80 years with breast cancer.</div></div><div><h3>Materials and methods</h3><div>We used the 2016–2019 SEER-Medicare data to identify women aged ≥66 years who initiated AET in 2017. Eligible patients had hormone receptor–positive, stage I–III breast cancer diagnosed within one year prior to AET initiation (index date). Comorbidities were defined using Clinical Classifications Software Refined (CCSR) codes. To identify comorbidity patterns, we applied agglomerative hierarchical clustering using Jaccard's dissimilarity index and Ward's minimum variance method to the top 50 CCSR categories across four periods: pre-index, post–year 1, post–year 2, and EOL.</div></div><div><h3>Results</h3><div>We identified 11,551 women, of whom 11,050 were alive at the end of follow-up and 501 died during follow-up. Among the patients who were alive, more than 50% had ≥2 chronic conditions across the observation windows. Cardiovascular diseases and their associated risk factors showed the largest increase over time. The most consistent and prevalent cluster across post–year 1, post–year 2, and EOL was “cardiovascular and pulmonary diseases,” including hypertension, coronary atherosclerosis, with additional respiratory and kidney-related conditions emerging near EOL.</div></div><div><h3>Discussion</h3><div>Comorbidity clustering was common and persisted across observation windows, with cardiovascular and related conditions prominent and expanding near EOL. These patterns highlight the need for integrated cardio-oncology and geriatric co-management to address the complex care needs of older women receiving AET.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102852"},"PeriodicalIF":2.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}