An observational study for evaluating predictability of the Vulnerable Elders Survey (VES) -13 for cognitive impairment in elderly patients with advanced cancer

2016 Fiscal Year Annual Research Report

• Project/Area Number: 25460896
• Research Institution: Nagoya University
• Principal Investigator: 安藤 昌彦 名古屋大学, 医学部附属病院, 准教授 (10322736)
• Co-Investigator(Kenkyū-buntansha): 長谷 哲成 名古屋大学, 医学部附属病院, 助教 (30621635) ; 森瀬 昌宏 名古屋大学, 医学部附属病院, 病院助教 (00612756)
• Project Period (FY): 2013-04-01 – 2017-03-31
• Keywords: 高齢者 / がん / 化学療法 / 機能評価 / アウトカム予測

Outline of Annual Research Achievements

本研究では、高齢者の代表的ながん種である非小細胞肺癌を対象に、脆弱性評価指標Vulnerable Elders Survey-13（VES-13）ならびに認知機能評価指標Mini-Mental State Examination（MMSE）について、両派の関連の程度ならびに予後や治療アウトカムとの関連について検討した。
14施設から101例が登録され、VES-13・MMSE評価を実施した。対象者の年齢は中央値72歳（範囲65-84）、VES-13スコアは中央値1点（範囲0-7）、MMSEスコアは中央値28点（範囲22-30）、また合併症スコアであるCharlson Comorbidity Index（CCI）は中央値0点（範囲0-4）であった。
VES-13・MMSE・CCIと臨床アウトカムの関連について、全生存期間・無増悪生存期間・抗腫瘍効果をアウトカムとするCox比例ハザードモデルを用いて評価を行った結果、全生存期間と有意な関連が見られたのはVES-13スコアであり、無増悪生存期間と有意な関連が見られたのはPerformance status、VES-13スコア、CCIスコアであった。年齢はいずれも有意な関連を認めなかった。高齢非小細胞肺癌者における化学療法アウトカム予測において年齢は予測因子とならない一方、初回化学療法開始前に脆弱性や認知機能、合併症に関する評価を実施することの意義を強く示唆する結果であり、今後学会ならびに論文発表する予定である。
関連する研究である、70歳以上の進行非小細胞肺癌患者に対するプラチナ製剤を含む併用化学療法の忍容性予測に関する後ろ向き研究については、198例のデータにおいて血清アルブミン低値が腫瘍増大がみられないにもかかわらず2サイクルの化学療法を完遂できない症例の予測に役立つ可能性があるとの知見が得られ、論文として公表された。

Research Products

• [Journal Article] Risk Factors for Postoperative Delirium in Abdominal Surgery: A Proposal of a Postoperative Delirium Risk Score in Abdominal Surgery (2016)
  • Author(s): Yasuhiro Miyagawa, Yukihiro Yokoyama, Shota Fukuzawa, Shinji Fukata, Masahiko Ando, Takashi Kawamura, Kiyofumi Yamada. and Masato Nagino
  • Journal Title: Dig Surg Volume: 34 Pages: 95-102
  • DOI: 10.1159/000449044
  • Peer Reviewed
• [Journal Article] A randomized Phase III trial of thoracoscopic versus open esophagectomy for thoracic esophageal cancer: Japan Clinical Oncology Group Study JCOG1409 (2016)
  • Author(s): Kozo Kataoka, Hiroya Takeuchi, Junki Mizusawa, Masahiko Ando, Yasuhiro Tsubosa, Kazuo Koyanagi, Hiroyuki Daiko, Satoru Matsuda, Kenichi Nakamura, Ken Kato, and Yuko Kitagawa
  • Journal Title: Jpn J Clin Oncol Volume: 46 Pages: 174-177
  • DOI: 10.1093/jjco/hyv178
  • Peer Reviewed
• [Journal Article] Impact of Registered Dietitian Expertise in Health Guidance for Weight Loss (2016)
  • Author(s): Mie Imanaka, Masahiko Ando, Tetsuhisa Kitamura, and Takashi Kawamura
  • Journal Title: PLoS One Volume: 11 Pages: e0151456
  • DOI: 10.1371/journal.pone.0151456
  • Peer Reviewed
• [Journal Article] Prospective analysis on oncogenic driver mutations and environmental factors: Japan Molecular Epidemiology for lung cancer study (JME) (2016)
  • Author(s): 2.Tomoya Kawaguchi, Yasuhiro Koh, Masahiko Ando, Norimasa Ito, Sadanori Takeo, Hirofumi Adachi, Tsutomu Tagawa, Seiichi Kakegawa, Motohiro Yamashita, Kazuhiko Kataoka, Yukito Ichinose, Yukiyasu Takeuchi, Masakuni Serizawa, Akihiro Tamiya, Shigeki Shimizu, Naoki Yoshimoto, Akihito Kubo, Shun-ichi Isa, Hideo Saka
  • Journal Title: J Clin Oncol Volume: 34 Pages: 2247-2257
  • DOI: 10.1200/JCO.2015.64.2322
  • Peer Reviewed
• [Journal Article] Mean pulmonary arterial pressure as a prognostic indicator in connective tissue disease associated with interstitial lung disease: a retrospective cohort study (2016)
  • Author(s): Kota Takahashi, Hiroyuki Taniguchi, Masahiko Ando, Koji Sakamoto, Yasuhiro Kondoh, Naohiro Watanabe, Tomoki Kimura, Kensuke Kataoka, Atsushi Suzuki, Satoru Ito, and Yoshinori Hasegawa
  • Journal Title: BMC Pulm Med Volume: 16 Pages: 55
  • DOI: 10.1186/s12890-016-0207-3
  • Peer Reviewed
• [Journal Article] Can we predict the development of serious adverse events (SAEs) and early treatment termination in elderly non-small cell lung cancer (NSCLC) patients receiving platinum-based chemotherapy? (2016)
  • Author(s): 1.Toshio Kato, Masahiro Morise, Masahiko Ando, Eiji Kojima, Tomohiko Ogasawara, Ryujiro Suzuki, Joe Shindoh, Masami Matsumoto, Yasuteru Sugino, Masahiro Ogawa, Yasuhiro Nozaki, Tetsunari Hase, Masashi Kondo, Hiroshi Saito, and Yoshinori Hasegawa
  • Journal Title: J Cancer Res Clin Oncol Volume: 142 Pages: 1629-1640
  • DOI: 10.1007/s00432-016-2170-z
  • Peer Reviewed
• [Journal Article] Randomized control trial for the assessment of the anti-albuminuric effects of topiroxostat in hyperuricemic patients with diabetic nephropathy (the ETUDE study) (2016)
  • Author(s): Sawako Kato, Masahiko Ando, Toshihiro Mizukoshi, Takanobu Nagata, Takayuki Katsuno, Tomoki Kosugi, Naotake Tsuboi and Shoichi Maruyama
  • Journal Title: Nagoya J Med Sci Volume: 78 Pages: 123-134
  • Peer Reviewed
• [Journal Article] Factors Affecting the Diagnostic Yield of Transbronchial Biopsy Using Endobronchial Ultrasonography with a Guide Sheath in Peripheral Lung Cancer (2016)
  • Author(s): Shotaro Okachi, Naoyuki Imai, Kazuyoshi Imaizumi, Shingo Iwano, Masahiko Ando, Tetsunari Hase, Hiromichi Aso, Masahiro Morise, Keiko Wakahara, Satoru Ito, Naozumi Hashimoto, Mitsuo Sato, Masashi Kondo, and Yoshinori Hasegawa
  • Journal Title: Intern Med Volume: 55 Pages: 1705-1712
  • DOI: 10.2169/internalmedicine.55.6341
  • Peer Reviewed
• [Journal Article] Association between falls and depressive symptoms or visual impairment among Japanese young-old adults (2016)
  • Author(s): Reiji Kojima, Masahiko Ando, Takashi Kawamura, Kenji Wakai, Kazuyo Tsushita, and Akiko Tamakoshi
  • Journal Title: Geriatr Gerontol Int Volume: 16 Pages: 384-391
  • DOI: 10.1111/ggi.12487
  • Peer Reviewed
• [Journal Article] Phase II Study of Carboplatin and Pemetrexed in Advanced EGFR-wild-type Non-squamous Non-small Cell Lung Cancer: The Central Japan Lung Study Group Trial 0906 (2016)
  • Author(s): Tomoki Kimura, Hiroyuki Taniguchi, Joe Shindo, Tomohiko Ogasawara, Eiji Kojima, Yoshinori Hasegawa, Masashi Yamamoto, Naohiro Watanabe, Hideo Saka, Yoshihito Kogure, Ryujiro Suzuki, Masahiko Ando, Masashi Kondo, and Hiroshi Saito
  • Journal Title: Anticancer Res Volume: 36 Pages: 1767-1772
  • Peer Reviewed