{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:33Z","timestamp":1792785993649,"version":"4.5.0"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000147","name":"Canadian Cancer Society","doi-asserted-by":"publisher","award":["#705046"],"award-info":[{"award-number":["#705046"]}],"id":[{"id":"10.13039\/501100000147","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canada Research Chair in the Care of Frail Older Adults"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frailty and multimorbidity among older cancer patients affect treatment tolerance and efficacy. Comprehensive geriatric assessment and management is recommended to optimize cancer treatment, but its effect on various outcomes remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Our objective was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) and cost-effectiveness studies comparing comprehensive geriatric assessment (with or without implementation of recommendations) to usual care in older cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched MEDLINE, EMBASE, CINAHL, and Cochrane trials from inception to January 27, 2023, for RCTs and cost-effectiveness studies. Pooled estimates for outcomes were calculated using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 19 full-text articles representing 17 RCTs were included. Average participant age was 72-80\u2009years, and 31%-62% were female. Comprehensive geriatric assessment type, mode of delivery, and evaluated outcomes varied across studies. Meta-analysis revealed no difference in risk of mortality (risk ratio [RR] = 1.08. 95% confidence interval [CI] = 0.91 to 1.29), hospitalization (RR = 0.92, 95% CI = 0.77 to 1.10), early treatment discontinuation (RR\u2009=\u20090.89, 95% CI = 0.67 to 1.19), initial dose reduction (RR\u2009=\u20090.99, 95% CI = 0.99 to 1.26), and subsequent dose reduction (RR\u2009=\u20090.87, 95% CI = 0.70 to 1.09). However, the risk of treatment toxicity was statistically significantly lower in the comprehensive geriatric assessment group (RR\u2009=\u20090.78, 95% CI = 0.70 to 0.86). No cost-effectiveness studies were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with usual care, comprehensive geriatric assessment was not associated with a difference in risk of mortality, hospitalization, treatment discontinuation, and dose reduction but was associated with a lower risk of treatment toxicity indicating its potential to optimize cancer treatment in this population. Further research is needed to evaluate cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djad200","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T16:07:21Z","timestamp":1695053241000},"page":"1483-1496","source":"Crossref","is-referenced-by-count":46,"title":["Effectiveness of geriatric assessment and management in older cancer patients: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9778-4961","authenticated-orcid":false,"given":"Mohammed Rashidul","family":"Anwar","sequence":"first","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shant Torkom","family":"Yeretzian","sequence":"additional","affiliation":[{"name":"Turpanjian College of Health Sciences, American University of Armenia , Yerevan, Armenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Patricia","family":"Ayala","sequence":"additional","affiliation":[{"name":"Gerstein Science Information Centre, University of Toronto , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Matosyan","sequence":"additional","affiliation":[{"name":"University of Western Ontario , London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette","family":"Breunis","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, University Health Network , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathyrin","family":"Bote","sequence":"additional","affiliation":[{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Puts","sequence":"additional","affiliation":[{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Hassan","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Health Network , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qixuan","family":"Li","sequence":"additional","affiliation":[{"name":"Biostatistics Research Unit, University Health Network , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeva","family":"Sahakyan","sequence":"additional","affiliation":[{"name":"Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabbir M H","family":"Alibhai","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto , Toronto, ON, Canada"},{"name":"Department of Medicine, University Health Network , Toronto, ON, Canada"},{"name":"Department of Medicine, University of Toronto , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2788-4179","authenticated-orcid":false,"given":"Lusine","family":"Abrahamyan","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto , Toronto, ON, Canada"},{"name":"Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network , Toronto, ON, Canada"},{"name":"Toronto General Hospital Research Institute, University Health Network , Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,20]]},"reference":[{"issue":"1","key":"2023120620184085800_djad200-B1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/ijc.31664","article-title":"Global cancer incidence in older adults, 2012 and 2035: a population-based study","volume":"144","author":"Pilleron","year":"2019","journal-title":"Int J Cancer"},{"issue":"6","key":"2023120620184085800_djad200-B2","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.3390\/cancers13061400","article-title":"Cancer and aging: two tightly interconnected biological processes","volume":"13","author":"Berben","year":"2021","journal-title":"Cancers (Basel)"},{"issue":"6","key":"2023120620184085800_djad200-B3","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1200\/JOP.2011.000460","article-title":"Multimorbidity: an issue of growing importance for oncologists","volume":"7","author":"Ritchie","year":"2011","journal-title":"J Oncol Pract"},{"issue":"24","key":"2023120620184085800_djad200-B4","doi-asserted-by":"crossref","first-page":"2595","DOI":"10.1200\/JCO.2013.54.8347","article-title":"International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer","volume":"32","author":"Wildiers","year":"2014","journal-title":"J Clin Oncol"},{"issue":"9","key":"2023120620184085800_djad200-B5","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1016\/j.ejca.2010.02.022","article-title":"EORTC elderly task force position paper: approach to the older cancer patient","volume":"46","author":"Pallis","year":"2010","journal-title":"Eur J Cancer"},{"issue":"22","key":"2023120620184085800_djad200-B6","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1200\/JCO.2018.78.8687","article-title":"Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology","volume":"36","author":"Mohile","year":"2018","journal-title":"J Clin Oncol"},{"issue":"9","key":"2023120620184085800_djad200-B7","first-page":"1006","article-title":"NCCN guidelines\u00ae insights: older adult oncology, version 1.2021: featured updates to the NCCN guidelines","volume":"19","author":"Dotan","year":"2021"},{"issue":"6","key":"2023120620184085800_djad200-B8","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1177\/107327480301000603","article-title":"Comprehensive geriatric assessment","volume":"10","author":"Wieland","year":"2003","journal-title":"Cancer Control"},{"issue":"1","key":"2023120620184085800_djad200-B9","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1093\/ageing\/afx166","article-title":"What is comprehensive geriatric assessment (CGA)? 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