Multidimensional geriatric evaluation for older cancer patients as a clinical and research tool

Abstract

The comprehensive geriatric assessment (CGA), originally developed by geriatricians as a multidimensional evaluation of the older patients, has become in the recent years a fundamental aid for evaluation and treatment planning of older cancer patients. Traditional parameters used by oncologists (such as performance status assessment) are insufficient to properly address older cancer patients' issues. Therefore CGA encompasses several items which help to identify, manage and possibly correct issues which could interfere with oncologic treatment. Items in the CGA are determination of functional and cognitive status, assessment of depression, assessment of nutritional status and of all associated diseases. CGA provides a thorough review of the global health of older patients, allowing tailoring of treatment for fit, vulnerable and frail patients. Beside its clinical importance, CGA constitutes a major tool in research for elderly cancer patients, since it provides better categorization of patients for enrolment in clinical trials and consent comparison of results among homogenous cohorts of patients. CGA should therefore be always performed when approaching elderly cancer patients, yet it might be time-consuming in the common practice. To overcome this issue, shortened forms of CGA are being implemented.