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Comprehensive geriatric assessment for older women with early breast cancer – a systematic review of literature.doc

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Comprehensive geriatric assessment for older women with early breast cancer – a systematic review of literature

Parksetal.WorldJournalofSurgicalOncology2012,10:88 /content/10/1/88 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH OpenAccess Comprehensivegeriatricassessmentforolder womenwithearlybreastcancer–asystematic reviewofliterature 1 1 2 3 4 RuthMParks,RadhikaLakshmanan ,LindaWinterbottom,DavidALMorgan ,KarenCox and Kwok-LeungCheung1,5* Abstract Background:TheComprehensiveGeriatricAssessment(CGA)isananalyticaltoolincreasinglyimplementedin clinicalpractice.Breastcancerisprimarilyadiseaseofolderpeople;however,mostevidence-basedresearchis aimedatyoungerpatients. Methods:AsystematicreviewofliteraturewascarriedouttoassesstheuseofCGAinolderbreastcancerpatients forclinicaldecisionmaking.ThePubMed,EmbaseandCochranedatabasesweresearched. Results:Atotalofnineusefulfulltextarticleresultswerefound.Onlyfiveofthesewereexclusivelyconcernedwith earlybreastcancer;thus,studiesinvolvingavarietyofcancertypes,stagesandtreatmentswereaccepted,aslong astheyincludedearlybreastcancer.Theresultscomprisedaseriesoflowsourcesofevidence.However,allresults sharedacommontheme:theCGAhasauseindeterminingpatientsuitabilityfordifferenttypesofcancer treatmentandsubsequentlymaximizingthepatient’squalityoflife. Conclusions:ThereisnotyetsufficienthighlevelevidencetoinstateCGAguidelinesasamandatorypracticein themanagementofbreastcancer,duetotheheterogeneityofavailablestudies.Morestudiesneedtobe conductedtocementcurrentworkonthebenefitsoftheCGA.Anareaofparticularinterestiswithregardto treatmentoptions,especiallysurgeryandchemotherapy,andidentifyingpatientswhomaybesuitableforthese treatments. Keywords:Comprehensivegeriatricassessment,Primary,Operable,Breastcancer,Early Background Disadvantages of CGA include additional time of im- The Comprehensive Geriatric Assessment (CGA) is a plementation and limited consensus regarding method- multidisciplinarymanagementtoolaimedatdetermining ology, evaluation and utilization [3]. Comprehensive an older person’s medical, psychological and functional geriatric assessm