Overall survival in older patients with cancer

BMJ Support Palliat Care. 2020 Mar;10(1):25-35. doi: 10.1136/bmjspcare-2018-001516. Epub 2018 Sep 22.


Objectives: A growing number of patients with cancer are older adults. We sought to identify the predictors for overall survival (OS) in older adults with solid tumour and haematological malignancies between January 2013 and December 2016.

Methods: Retrospective cohort study. A comprehensive geriatric assessment was performed, with a median follow-up of 12.8 months.

Analysis: univariate and multivariate Cox proportional hazards regression analysis.

Results: In this study, among the 455 patients with last follow-up date or date of death, 152 (33.4%) died during the follow-up. The median follow-up is 12.8 months (range 0.2-51.1 months) and the median OS is 20.5 months (range 0.3-44.5 months). Among all older patients with cancer, predictors of OS included male gender, cancer stage, malnutrition, history of smoking, heavy alcohol use, frailty, weight loss, major depression, low body weight and nursing home residence. Traditional performance scores (Eastern Cooperative Oncology Group (ECOG) and Karnofsky Performance Scale (KPS)) were predictors of OS. Independent predictors included age >85 years and haematological malignancies. Among solid tumours (n=311) in addition to the above predictors, comorbidity, gait speed and vitamin D deficiency were associated with OS.

Conclusions: We identified specific geriatric factors associated with OS in older patients with cancer, and comparable in predictive ability to traditional performance scores such as KPS and ECOG. Prospective studies will be necessary to confirm our findings.

Keywords: cognitive impairment; depression; functional impairment; older adults with cancer; social support; survival.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Geriatric Assessment
  • Humans
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / mortality*
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Analysis