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Publications

Journal Article Ahead of print

PubMed: 41233219 DOI: 10.1016/j.jgo.2025.102812

Important aspects of care and priorities of older patients with cancer: The PRIORITY multicenter cohort study.

J Geriatr Oncol

Authors: Thomas Grellety, Carine Bellera, Coralie Cantarel, Cécile Mertens, Mathilde Cabart, Guilhem Roubaud, Marie-Claude Chantecaille, Hervé Desclos, Corinne Souyris, Patrick Bouchaert, Emmanuelle Bourbouloux, Catherine Terret, Cécile Delattre, Laurent Cany, Caroline Lalet, Simone Mathoulin-Pelissier, Pierre Soubeyran, Camille Chakiba Brugere

Affiliations

  • Medical Oncology Department, Institut de Cancérologie Navarre Côte Basque, Centre Hospitalier de la Côte Basque, Bayonne, France.
  • Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Epicene team, UMR 1219, F-33000 Bordeaux, France; Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France.
  • Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France.
  • Oncogeriatry Department, CHU Bordeaux, Bordeaux, France.
  • Medical Oncology Department, Institut Bergonié, Bordeaux, France.
  • Medical Oncology Department, Hopital Broussais, St Malo, France.
  • Medical oncology Department, Centre Hospitalier Intercommunal Castres-Mazamet, Castres, France.
  • Medical Oncology Department, CHU de Poitiers, Poitiers, France.
  • Medical Oncology Department, ICO Institut de Cancerologie de l'Ouest René Gauducheau, Saint-Herblain, France.
  • Medical Oncology Department, Centre Léon Bérard, Lyon, France.
  • Geriatric Oncology Department, Institut de Cancérologie de Lorraine - Alexis Vautrin, Vandoeuvre-lès-Nancy, France.
  • Medical Oncology Department, Hôpital privé Francheville, Périgueux, France.
  • Clinical and Epidemiological Research Unit, Institute Bergonié, Bordeaux, France.
  • Medical Oncology Department, Institut Bergonié, Bordeaux, France; Bordeaux Institute of Oncology, Inserm U1312, Univ. Bordeaux, Bordeaux, France.

Abstract

INTRODUCTION

Data on treatment preferences in older cancer patients are lacking. We aimed to identify their priorities.

MATERIALS AND METHODS

We conducted a multicenter prospective cohort study on patients with cancer aged ≥70 and 18-69, initiating first medical treatment. Patients and physicians prioritized eight aspects of care: treatment efficacy, life expectancy, autonomy, daily tasks, social activities, treatment burden, toxicity, and economic burden via self-completed questionnaires. The primary endpoint was the priorities of older patients.

RESULTS

We included 233 older and 100 younger patients at eight sites. In the older patient cohort, median age was 79 (min-max: 70-97), breast cancer represented 34 % (N = 78) and lung 12 % (N = 27). Metastatic setting concerned 45 % of the patients. The most frequently rated top priority at treatment initiation was treatment efficacy in both older (73 %) and younger cohorts (79 %), followed by autonomy in the older cohort (13 %) and life expectancy in the younger cohort (14 %). Treatment efficacy was almost systematically cited in the top four priorities for both older (94 %) and younger patients (96 %), followed by autonomy (86 %) for older and life expectancy (82 %) for younger patients. These priorities were stable (>70 %) between initiation and three months for each cohort. Agreement rate for prioritization of aspects of care between older patients and physicians was 87 % for treatment efficacy and 64 % for autonomy.

DISCUSSION

Autonomy was the second most cited priority among older patients, yet many physicians failed to recognize this, potentially affecting treatment decisions. These findings highlight the need for shared decision-making to align treatment choices with patient expectations.

MeSH

Treatment Outcome, Neoplasms, Cohort Studies, Life Expectancy, Physicians, Therapeutics