Older patients with cancer are heterogeneous in physical condition, age-related conditions (geriatric deficits), treatment tolerance and treatment goals. A geriatric assessment can be performed to identify geriatric deficits. The available evidence to decide on optimal treatment is often lacking due to underrepresentation of this group in clinical trials. The aim of this thesis was to improve the identification of older patients with cancer who will benefit from treatment and those who will not by using geriatric assessment and blood biomarkers. We showed that observational data provide valuable knowledge on geriatric assessment and outcomes in older patients that are representative for patients seen in daily practice. Geriatric deficits were highly prevalent in the cohorts that we studied and related to adverse outcomes in older patients with esophageal cancer. Lastly, we showed that evidence on useful blood biomarkers in relation to outcomes is scarce and the blood biomarkers we studied did not improve mortality prediction on top of clinical predictors that are already used. The stratification of older patients with cancer can be improved by incorporating a geriatric assessment into routine care. Blood biomarkers need validation in large groups of older patients with one type of cancer before they become clinically useful.
Y. van Holstein (Wed,) studied this question.