全球指南建议所有接受化疗的老年癌症患者应接受老年评估。然而，老年评估的利用往往受到其时间密集性的限制，这限制了其在资源有限和需求高的环境中的采用。缺乏证据将老年评估结果与印度次大陆的生存率联系起来。因此，本研究的目的是评估老年评估对印度老年癌症患者生存的影响，并确定与这些老年癌症患者生存相关的因素。这是一项观察性研究，在老年肿瘤诊所进行塔塔纪念医院（印度孟买）。纳入了接受老年评估的 60 岁及以上癌症患者。我们评估了非肿瘤老年领域的功能和跌倒、营养、合并症、认知、心理学、社会支持和药物治疗。在两个或多个领域表现出损伤的患者被归类为虚弱。2018 年 6 月至 2022 年 1 月期间，我们招募了 897 名患者。中位年龄为 69 岁（四分位间距 65-73）岁。常见的恶性肿瘤为肺癌（40.5%）、食道癌（31.9%）和泌尿生殖系统（12.1%）； 54.6%患有转移性疾病。根据老年评估结果，767 名（85.4%）患者身体虚弱。健康患者的估计中位总生存期为 24.3（95% 置信区间 18.2-未达到）个月，而体弱患者的估计中位总生存期为 11.2（10.1-12.8）个月（风险比 0.54；95% 置信区间 0.41-0.72，P < 0.001 ）。在调整年龄、性别、原发肿瘤和转移状态后，总生存率的这种差异仍然显着（风险比 0.56；95% 置信区间 0.41-0.74，P < 0.001）。在体能状态为 0 或 1 的患者 (n = 454) 中，365 名 (80.4%) 身体虚弱；健康状态 0-1 组的中位总生存期为 33.0 个月（95% 置信区间 24.31-未达到），而体弱患者的中位总生存期为 14.4 个月（95% 置信区间 12.25-18.73）（风险比 0.50； 95% 置信区间 0.34-0.74，P = 0.001)。在多变量分析中，预测生存的老年评估领域是功能（风险比 0.68；95% 置信区间 0.52-0.88；P = 0.003）、营养（风险比 0.64；95% 置信区间 0.48-0.85，P = 0.002）和认知（风险比 0.67；95% 置信区间 0.49-0.91，P = 0.011）。老年评估是印度老年癌症患者生存的有力预后工具。即使在被认为最适合的患者群体（即表现状态 0 和 1）中，老年评估也具有预后意义。我们的研究再次强调了老年评估对于计划进行癌症定向治疗的所有老年患者的至关重要性。版权所有 © 2023 . 爱思唯尔有限公司出版

Global guidelines recommend that all older patients with cancer receiving chemotherapy should undergo a geriatric assessment. However, utilisation of the geriatric assessment is often constrained by its time-intensive nature, which limits its adoption in settings with limited resources and high demand. There is a lack of evidence correlating the results of the geriatric assessment with survival from the Indian subcontinent. Therefore, the aims of the present study were to assess the impact of the geriatric assessment on survival in older Indian patients with cancer and to identify the factors associated with survival in these older patients.This was an observational study, conducted in the geriatric oncology clinic of the Tata Memorial Hospital (Mumbai, India). Patients aged 60 years and older with cancer who underwent a geriatric assessment were enrolled. We assessed the non-oncological geriatric domains of function and falls, nutrition, comorbidities, cognition, psychology, social support and medications. Patients exhibiting impairment in two or more domains were classified as frail.Between June 2018 and January 2022, we enrolled 897 patients. The median age was 69 (interquartile range 65-73) years. The common malignancies were lung (40.5%), oesophagus (31.9%) and genitourinary (12.1%); 54.6% had metastatic disease. Based on the results of the geriatric assessment, 767 (85.4%) patients were frail. The estimated median overall survival in fit patients was 24.3 (95% confidence interval 18.2-not reached) months, compared with 11.2 (10.1-12.8) months in frail patients (hazard ratio 0.54; 95% confidence interval 0.41-0.72, P < 0.001). This difference in overall survival remained significant after adjusting for age, sex, primary tumour and metastatic status (hazard ratio 0.56; 95% confidence interval 0.41-0.74, P < 0.001). In the patients with a performance status of 0 or 1 (n = 454), 365 (80.4%) were frail; the median overall survival in the performance status 0-1 group was 33.0 months (95% confidence interval 24.31-not reached) in the fit group versus 14.4 months (95% confidence interval 12.25-18.73) in the frail patients (hazard ratio 0.50; 95% confidence interval 0.34-0.74, P = 0.001). In the multivariate analysis, the geriatric assessment domains that were predictive of survival were function (hazard ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.003), nutrition (hazard ratio 0.64; 95% confidence interval 0.48-0.85, P = 0.002) and cognition (hazard ratio 0.67; 95% confidence interval 0.49-0.91, P = 0.011).The geriatric assessment is a powerful prognostic tool for survival among older Indian patients with cancer. The geriatric assessment is prognostic even in the cohort of patients thought to be the fittest, i.e. performance status 0 and 1. Our study re-emphasises the critical importance of the geriatric assessment in all older patients planned for cancer-directed therapy.Copyright © 2023. Published by Elsevier Ltd.