Quality of life determinants in older patients with cancer: Results from a French prospective monocenter cohort.

OBJECTIVES: The aim of this study is to describe determinants of quality of life (QOL) quoted by vulnerable older patients with cancer and compare them with domains included in cancer-specific QOL questionnaires. MATERIAL AND METHODS: This prospective, monocenter, observational study was performed in a French university hospital. Cancer patients Patients with cancer aged over 74 years were recruited when referred for an out-patient geriatric evaluation (n = 102). After geriatric assessment, they were invited to respond to open-ended questions, Q1: "For you, what is most important to have a good QOL?" Q2: "What could improve your QOL?" Q3: "What could worsen your QOL?" A Delphi process was conducted to categorize patient responses according to content analysis. RESULTS: The most frequently patient-reported determinants for high quality of life were maintaining close ties with family/friends or social relations, autonomy for decision and mobility without depending on others, being in good health, not suffering from pain and the absence of problems concerning relatives. Global health status, physical functioning/mobility, social functioning and worries about others were the more frequently mentioned QOL domains related to the EORTC QLQ-C30 and ELD14 questionnaires. Some determinants of QOL were not linked to pre-defined domains, some others without a 100% consensus after the Delphi process, illustrating the subjectivity of QOL analysis by a single practitioner. CONCLUSION: Patient interview with open-ended questions provides valuable supplementary information to QOL questionnaires, in order to personalize health related (cancer treatment, pain management…) and global (maintenance of autonomy and family/social relations…) assessment and intervention.

Endoscopic retrograde cholangiopancreatography in the elderly over 75 years old: a survey.

Whilst endoscopic retrograde cholangiopancreatography (ERCP) is being practiced on increasingly older patients, its benefits have not been well studied. This study assessed the clinical benefit of ERCP for subjects aged 75 and over, including follow-up at 3 months of geriatric functional parameters and lifestyle. This is a prospective mono-centric, cohort study. All patients aged 75 and over receiving ERCP were enrolled and monitored for a period of 3 months. We recorded 53 inclusions between November 1st 2014 to 31 May 2015. Our "ill-type" was a fragile polypathology woman of 85 years, living at home, with loss of autonomy for instrumental activities of daily living (IADL). Lithiasis was diagnosed in 56.6% of cases, and malignant stenosis in 35.8% of cases. The success rate was 88.7% with a 5.7% complication rate. At 3 months, we observed no clinically significant change in ADL parameters, IADL and lifestyle. Our follow-up data support the practice of ERCP in geriatric populations.