FASTOCH: Feasibility of Electronic Patient-Reported Outcomes in Older Patients With Cancer-A Multicenter Prospective Study.

PURPOSE: Multiple studies have demonstrated that electronic patient-reported outcomes (ePROs) improve overall survival and quality of life in cancer care. However, there are no specific prospective data on remote ePRO monitoring in the older population, although they represent a significant proportion of patients with cancer. PATIENTS AND METHODS: From February 2021 to April 2022, patients age 75 years and older under active anticancer treatment were consecutively recruited in six institutions. Remote ePRO feasibility was determined in intention-to-test (ITT) on the basis of the number of active users in the overall population. Primary failure applied to patients who had no Internet access or declined to test ePROs, while the other patients were assigned to the ITT population. Feasibility was also determined per-protocol on the basis of the number of active patients in the ITT population. RESULTS: Of the 473 patients included, primary failure applied to 288 patients (233 of whom had no Internet access). Among the 185 patients in ITT, 122 used ePROs, leading to a 26% feasibility in ITT and a 66% feasibility per protocol. In a multivariate analysis, the intent to test population was from a higher socioprofessional category (P = .009) and felt in better general condition in the Geriatric 8-score evaluation (P = .002). Active patients significantly differed from the inactive on their self-assessment of a better general condition (P < .001) only. CONCLUSION: Our multicenter study showed a limited feasibility rate (26%) of remote ePROs monitoring for older patients with cancer, mainly because of technology barriers. Yet, among the patients who did have Internet access, most of them indeed used ePROs (66%). Given the expected benefit of ePROs, the technology barriers therefore need to be lifted to improve cancer care in older patients.

Geriatric factors associated with overall survival in older patients with metastatic colorectal cancer.

Advanced age in patients with colorectal cancer is a factor of poor prognosis, but little is known about geriatric factors associated with survival and chemotherapy prescription in frail elderly patients. Our research sought to investigate these factors in older patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS: patients aged ≥75 years, who were treated for mCRC and have had a Comprehensive Geriatric Assessment (CGA) due to their frailty, were included in this multicenter practice study in the Loire Valley region (France). With initial patient care for mCRC as the starting point, demographic, oncological, geriatric and survival data were collected from the regional cancer database and the medical record of each patient. We analyzed overall survival and chemotherapy prescription, according to the geriatric factors of the CGA. RESULTS: 108 patients were enrolled (mean age 84.0 +/- 4.5 years; 57.4 % men), among whom 53 (49 %) received at least one line of chemotherapy. The median overall survival [95 %CI] was 8.05 [5.6-12.0] months. In univariate analysis, prescription of chemotherapy was associated with the number of severe co-morbidities, number of co-medications, G8 score, BMI, MMSE score, IADL and ADL scores, Lee index and Balducci criteria. Survival was significantly associated with chemotherapy, ADL and IADL scores, G8 score, repeated falls, number of severe co-morbidities, MMSE score, Lee index and Balducci criteria. In multivariate analysis, only the ADL score (HR [95 %CI]: 0.74 [0.55-0.99], p = 0.04), number of severe co-morbidities (HR [95 %CI]: 1.62 [1.06-2.47], p = 0.03) and repeated falls (HR [95 %CI]: 3.54 [1.70-7.39], p < 0.001) were significantly associated with survival. CONCLUSION: in frail elderly patients with mCRC, dependency, co-morbidities and repeated falls are independent factors associated with survival. As such, there could be merit in taking these into consideration before the choice of oncological treatment is made.

A Quantitative Histologic Analysis of Oogenesis in the Flatfish Species Pleuronectes platessa as a Tool for Fisheries Management.

The following paper gives a detailed description of the oogenesis cycle for the European Plaice (Pleuronectes platessa), from oogonia to post-ovulatory follicle, including ovarian follicle and zona pellucida sizes. Noteworthy particularities were the difficulty in identifying cortical alveoli due to their very small size. Quantitative histology (stereology) on histological slides was used to determine a first size at maturity for females from the English Channel, which was found to be smaller compared to the literature (19 cm). Stereology also determined a first spawning event starting in January, with a peak in February and ongoing until March. Moreover, the use of stereology showed misclassifications for individuals categorized into a maturity phase using a macroscopic visual method. Misclassifications were found with individuals that had spawned (D) but were put under the immature (A) phase, and individuals in development (B) classified under D.

A macroscopic and stereological imaging dataset of Pleuronectes platessa ovaries.

The North Sea plaice, Pleuronectes platessa (Linnaeus, 1758), is a commonly studied commercial flatfish with poorly known ovarian histology. The following dataset is a collection of female plaice gonad images and their corresponding histological slides, collected during a complete season of the plaice's reproduction cycle. Stereology was used to determine the percentage of different structures found throughout the ovaries. Inter-agent calibrations were accomplished in order to harmonize the stereological readings, and were based on a comprehensive reading protocol and histological lexicon that were specifically written for the plaice's ovaries. The distribution and homogeneity of the different cell types found throughout the ovaries were also evaluated. This dataset can be used to automate the stereological reading process (through statistical learning methods for example) or to objectively determine the plaice's maturity phase, and link that information to either macroscopic measurements or through image analysis of the full ovaries.

Age and factors associated with access and time to post-operative adjuvant chemotherapy in colon cancer: a French epidemiological study.

BACKGROUND: Studies have shown the negative prognostic impact of increased time between colectomy and postoperative adjuvant chemotherapy (AC) in colon cancer (CC). Our aim was to investigate the role of age and non-organizational factors on access and time to AC. METHODS: All adult patients undergoing surgery for stage II or III CC in the "Région Centre-Val de Loire" in 2013, were selected. Time to AC and socio-demographic factors were collected. Logistic regression modeling was used to identify factors associated with access to AC, and a multivariate analysis performed to identify factors associated with time to AC. RESULTS: Among 404 stage II or III patients who underwent colectomy, 182 (45%; sex ratio 1.5; mean age 67.6 years; range 32-90) received AC. AC patients were younger than those without AC (67.6 vs. 77.9 years) and the difference was even greater for stage III patients (69.0 vs. 82.4). The median time to AC was 48 days, exceeding 42 days in 60% of cases. Living alone, postoperative morbidities, and emergency colectomy were independently associated with increased time to AC. Age and other factors were not associated with delayed AC. CONCLUSIONS: Emergency colectomy, postoperative morbidities, and living alone are associated with increased time to AC. Organizational measures to reduce the time to AC are therefore unlikely to have an impact. In contrast, age is not associated with increased time to AC, but to access to AC. Reasons for omitting AC in older patients requires further study.