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dc.contributor.authorFarag, S
dc.contributor.authorvan Coevorden, F
dc.contributor.authorSneekes, E
dc.contributor.authorGrunhagen, DJ
dc.contributor.authorReyners, AKL
dc.contributor.authorBoonstra, PA
dc.contributor.authorvan der Graaf, WT
dc.contributor.authorGelderblom, HJ
dc.contributor.authorSteeghs, N
dc.date.accessioned2017-12-14T15:17:39Z
dc.date.issued2017-11
dc.identifier.citationEuropean journal of cancer (Oxford, England : 1990), 2017, 86 pp. 318 - 325
dc.identifier.issn0959-8049
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/970
dc.identifier.eissn1879-0852
dc.identifier.doi10.1016/j.ejca.2017.09.017
dc.description.abstractObjective Although gastrointestinal stromal tumours (GIST) predominantly occur in older patients, data on treatment patterns in elderly GIST patients are scarce.Methods Patients registered in the Dutch GIST Registry (DGR) from January 2009 until December 2016 were included. Differences in treatment patterns between elderly (≥75 years) and younger patients were compared. Multivariate analyses were conducted using logistic regression.Results Data of 145 elderly and 665 non-elderly patients were registered (median age 78 and 60 years respectively). In elderly patients, performance score (WHO-PS) and age-adjusted Charlson comorbidity index (ACCI) were significantly higher (p < 0.05; p < 0.001), and albumin level significantly lower (p = 0.04). Hundred-and-nine (75.2%) elderly and 503 (75.6%) non-elderly patients had only localised disease. Surgery was performed in 57% of elderly versus 84% of non-elderly patients (p = 0.003, OR: 0.26, 95% CI: 0.11-0.63). No differences in surgery outcome or complications were found. Thirty-eight percent of elderly with an indication for adjuvant treatment did receive imatinib versus 68% of non-elderly (p = 0.04, OR: 0.47, 95% CI: 0.23-0.95). Thirty-six elderly and 162 non-elderly patients had metastatic disease. Palliative imatinib was equally given (mean dose 400 mg) and adverse events were mostly minor (p = 0.71). In elderly, drug-related toxicity was in 32.7% reason to discontinue imatinib versus 5.1% in non-elderly (p = 0.001, OR 13.5, 95% CI: 2.8-65.0). Median progression-free survival (PFS) was 24 months in elderly and 33 months in non-elderly (p = 0.10). Median overall survival (OS) was 34 months and 59 months respectively (p = 0.01).Conclusions Elderly GIST patients with localised disease receive less surgery and adjuvant treatment, irrespective of comorbidity and performance score. Drug-related toxicity results more often in treatment discontinuation. This possibly results in poor outcome.
dc.formatPrint-Electronic
dc.format.extent318 - 325
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
dc.subjectHumans
dc.subjectGastrointestinal Neoplasms
dc.subjectGastrointestinal Stromal Tumors
dc.subjectDisease Progression
dc.subjectAntineoplastic Agents
dc.subjectDisease-Free Survival
dc.subjectTreatment Outcome
dc.subjectChemotherapy, Adjuvant
dc.subjectDigestive System Surgical Procedures
dc.subjectRegistries
dc.subjectMultivariate Analysis
dc.subjectLogistic Models
dc.subjectOdds Ratio
dc.subjectRisk Factors
dc.subjectChi-Square Distribution
dc.subjectRetrospective Studies
dc.subjectAge Factors
dc.subjectComorbidity
dc.subjectHealth Status
dc.subjectTime Factors
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectDelivery of Health Care
dc.subjectNetherlands
dc.subjectFemale
dc.subjectMale
dc.subjectHealthcare Disparities
dc.subjectYoung Adult
dc.subjectKaplan-Meier Estimate
dc.subjectPractice Patterns, Physicians'
dc.subjectProcess Assessment, Health Care
dc.titleElderly patients with gastrointestinal stromal tumour (GIST) receive less treatment irrespective of performance score or comorbidity - A retrospective multicentre study in a large cohort of GIST patients.
dc.typeJournal Article
dcterms.dateAccepted2017-09-06
rioxxterms.funderThe Institute of Cancer Research
rioxxterms.identifier.projectUnspecified
rioxxterms.versionofrecord10.1016/j.ejca.2017.09.017
rioxxterms.licenseref.urihttps://www.rioxx.net/licenses/under-embargo-all-rights-reserved
rioxxterms.licenseref.startdate2017-11
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfEuropean journal of cancer (Oxford, England : 1990)
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical and Translational Sarcoma
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical and Translational Sarcoma
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume86
pubs.embargo.termsNot known
icr.researchteamClinical and Translational Sarcomaen_US
dc.contributor.icrauthorvan der Graaf, Wilhelminaen
dc.contributor.icrauthorMarsden,en


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