1385P - Abbreviated comprehensive geriatric assessment (CGA) in elderly cancer patients: preliminary results of an observational pilot study

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Geriatric Oncology
Presenter Oreste Mora
Authors O. Mora1, L. Marelli2, P. Quadri3, M. Tettamanti4, C. Pedrazzani2, M. Ghielmini5
  • 1Oncology, IOSI Istituto Oncologico Svizzera Italiana, 6500 - Bellinzona/CH
  • 2Medical Oncology, IOSI Istituto Oncologico Svizzera ItalianaOspedale Regionale Bellinzona e Valli, CH-6500 - Bellinzona/CH
  • 3Internal Medicine, Geriatric Department, Ospedale Beata Vergine, 6850 - Mendrisio/CH
  • 4Neuroscience, Istituto Mario Negri, Milano/IT
  • 5Medical Oncology, IOSIOspedale San Giovanni, CH-6500 - Bellinzona/CH

Abstract

Background

In Western countries elderly people constitute the fastest growing segment of the population and currently in our Institute patients aged ≥70 are about 45% of all cancer patients. CGA is a key component of the treatment approach for this population, but it is time-consuming.

Methods

This is an observational pilot study on consecutive therapy-naive elderly cancer patients (aged ≥ 70 years). The main aims were to verify the feasibility of an abbreviated CGA (aCGA) in an outpatient setting, the acceptability by patients, physicians, and nurses as well as the ability of this tool to discriminate the three prognostic classes of older cancer patients: fit, vulnerable, frail. Patients underwent aCGA (which consisted in filling in some short questionnaires, instead of the standard ones) with a medical oncologist (medical history, clinical examination, ECOG-performance status, Cumulative Illnesses Rating Scale-CIRS) and with a nurse (Activities Daily Living-ADL, Instrumental ADL, Mini Nutritional Assessment-MNA, cognitive Short Blessed Test, Geriatric Depression Scale-GDS, Quality of Life Health Survey-SF-12, motor status).

Results

From January 2010 to November 2011, 151 patients were enrolled. Median age was 77 (70-91) years, and 47% were males. Patients, doctors and nurses evaluated the information obtained by aCGA as, respectively: very useful in 47, 66, 42% and quite useful in 47, 28, 52%. The time required for the compilation of the questionnaires with nurses was <30 minutes in 40% of cases, 31-60 min in 43%, and >60 min in 17%. Physicians considered to have had no difficulty (83%) or little difficulty (10%) in compiling the form,. For nurses these figures were 40% and 43%. aCGA allowed to differentiate patients into three prognostic classes: fit 34%, vulnerable 36%, and frail 30%. Each of these classes was proposed for treatment which was curative in 76, 55, 35% of cases, palliative in 20, 35, 27% and supportive in 4, 10, 38% of cases, respectively.

Conclusions

aCGA is feasible in the outpatient setting. It is usually well accepted by patients, medical staff and nurses. It allows a distinction of prognosis of elderly cancer patients favouring an appropriate therapeutic choice.

Disclosure

All authors have declared no conflicts of interest.