Geriatric consults remain rare in kidney cancer care

(HealthDay)—Use of geriatric consultation remains sparse among older patients undergoing surgery for kidney cancer, according to a study published online Aug. 11 in the Journal of the American Geriatrics Society.

Hung-Jui Tan, M.D., from University of North Carolina at Chapel Hill, and colleagues used Surveillance, Epidemiology, and End Results cancer data linked with Medicare claims to identify 19,129 adults aged 65 and older with kidney cancer treated surgically from 2000 to 2009. The authors sought to evaluate provision of geriatric-related health care services by older adults undergoing surgery for kidney cancer.

The researchers found that geriatric consultation occurred rarely in the perioperative period (2.6 percent), although medical co-management (15.8 percent), inpatient physical or occupational therapy (PT/OT; 34.2 percent), and post-acute PT/OT (15.6 percent) occurred more frequently. Participant age and comorbidity burden appeared to be consistent determinants of use of services, although hospital-level variation was also noted (P < 0.001). In the latter years of the study, use of geriatric consultation increased modestly (P < 0.05), while medical co-management (183 percent), inpatient PT/OT (73 percent), and post-acute PT/OT (71 percent) increased substantially over the study period (P < 0.001).

"Efforts to reorganize cancer and surgery care should explore reasons for variation and the potential for these service elements to meet the health needs of an aging population," the authors write.

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