Follow-up of elderly patients with urogenital cancers: Evaluation of geriatric care needs and related actions ☆ , ☆☆ Silvio Monfardini a, ⁎, Sara Morlino b , Riccardo Valdagni c , Mario Catanzaro d , Ardit Tafa e , Barbara Bortolato f , Giovanni Petralia g , Elisa Bonetto h , Elisa Villa i , Stefano Picozzi j , Maria Cristina Locatelli k , Giuseppe Galetti a , Andrea Millul l , Yasmin Albanese l , Elisa Bianchi l , Claudia Panzarino a , Francesca Gerardi a , Ettore Beghi l a Istituto Palazzolo Fondazione Don Gnocchi, Milano, Italy b Radioterapia, Istituto Nazionale Tumori Milano, Italy c Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, Italy d Chirurgia Urologica Istituto Nazionale Tumori Milano, Italy e Clinica Urologica Università degli Studi Milano, Italy f Radioterapia Ospedale Niguarda, Milano, Italy g Urologia Ospedale Niguarda, Milano, Italy h Radioterapia Ospedale S. Gerardo, Monza, Italy i Radioterapia Istituto Clinico Humanitas, Rozzano, Italy j Urologia Ospedale Policlinico San Donato, San Donato Milanese, Italy k Oncologia Medica, Ospedale San Carlo, Milano, Italy l IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy abstract article info Article history: Received 6 October 2016 Received in revised form 2 January 2017 Accepted 28 February 2017 Available online xxxx Objectives: To investigate a comprehensive geriatric assessment (CGA) with subsequent investigation of healthcare patterns in older patients with urological cancers undergoing initial surgery or radiotherapy, to verify the usefulness of the incorporation of geriatric principles in future care plans. Material and Methods: This is a prospective cohort study. From November 2011 to March 2015, CGA was offered to all patients aged 70 + years treated with radiotherapy or surgery at seven tertiary centers. Patients were classified as fit, vulnerable, or frail according to Balducci's definition. CGA and follow-up data were collected by two trained eval- uators at 6 and 12 months. The information collected was not available to the caring physicians during follow-up. Results: CGA was performed in 453 patients with prostate cancer (295), bladder cancer (126), or kidney cancer (32). 40% of patients with prostate cancer were fit, 47% vulnerable, and 13% frail. The corresponding values for renal can- cer were 25%, 40%, and 34%, and for bladder cancer, 21%, 42%, and 37%. During follow-up, 60% of patients with car- diac diseases, 42% of those with diabetes/other metabolic disorders, 35% of those with hypertension, and 35% of those with respiratory diseases were followed by a specialist (for these severe/extremely severe comorbidities). Of 16 patients with ADL impairment and 63 with IADL impairment, only 4 (25%) and 6 (10%), respectively, were referred to a rehabilitation service. Only one case was referred to a geriatrician. Conclusions: Appropriate clinical care patterns are advisable to improve quality of survivorship in older patients with urological cancers. © 2017 Elsevier Ltd. All rights reserved. Keywords: Prostate cancer Renal cancer Bladder cancer Urogenital cancer Elderly Geriatric assessment 1. Introduction Sixty percent of cancer survivors in the United States in 2008 were adults aged 65 years or older and by the year 2020 two thirds of cancer survivors will be aged N 65 years [1]. Based on the number of patients with co-morbid conditions, approximately 50–75% of elderly patients with cancer are expected to need comprehensive, psychosocial, and physical support [2]. To deal with the complexity of the management of older patients in everyday practice, even in the absence of specific studies, the following options have been proposed: 1. a comprehensive geriatric assessment (CGA); this approach has been applied to evaluate older patients with cancer entering clinical trials [3–5]; and 2. interdisciplinary oncological- geriatric team activities [6,7]. Another way to deal with the complex and interdisciplinary care for older patients with cancer is the development of clinical care patterns Journal of Geriatric Oncology xxx (2017) xxx–xxx ☆ Supported by the Ministry of Health, Italy, grant RF-2009-1502045. The sponsor did not have a role in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. ☆☆ Presented at the 52nd ASCO Meeting. June 3–7, 2016. Chicago, Illinois. ⁎ Corresponding author at: Geriatric Oncology Program, Istituto Palazzolo, Fondazione Don Gnocchi, Via Palazzolo 21, 20149 Milano, Italy. E-mail address: smonfardini@dongnocchi.it (S. Monfardini). JGO-00420; No. of pages: 7; 4C: http://dx.doi.org/10.1016/j.jgo.2017.02.011 1879-4068/© 2017 Elsevier Ltd. All rights reserved. Contents lists available at ScienceDirect Journal of Geriatric Oncology Please cite this article as: Monfardini S, et al, Follow-up of elderly patients with urogenital cancers: Evaluation of geriatric care needs and related actions, J Geriatr Oncol (2017), http://dx.doi.org/10.1016/j.jgo.2017.02.011