1387P - Predictors of noncompletion of cancer treatments in elderly patients: the Elderly Cancer Patients (ELCAPA) Cohort Study

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Geriatric Oncology
Presenter Marie Laurent
Authors M. Laurent1, E. Paillaud1, M. Carvalho-Verlinde2, P. Caillet1, A. Le Thuaut3, E. Liuu1, S. Bastuji-Garin3, S. Culine4, F. Canouï-Poitrine3
  • 1Consultation D’onco-gériatrie (ucog Créteil), AP-HP, Hôpital Henri-Mondor, Département de Médecine Interne et Gériatrie, 94010 - Créteil/FR
  • 2Service De Pharmacie, AP-HP, Hôpital Henri-Mondor, 94010 - Créteil/FR
  • 3Pôle Recherche Clinique Et Santé Publique, AP-HP, Hôpital Henri-Mondor,, 94010 - Créteil/FR
  • 4Oncology, Hôpital Saint-Louis, 75010 - Paris/FR

Abstract

Background

The objective was to assess 1) prevalence and the predictors of non-completion of cancer treatments in elderly and 2) prognosis value of noncompletion of cancer treatments.

Methods

Between 2007-2010, 421 consecutive patients aged 70 years and older with solid tumors and indication of surgery, chemotherapy (CT), hormonal therapy (HT) or radiotherapy (RT) were included. Comprehensive Geriatric Assessment was performed at baseline. Patients were followed up for completion of surgery, first line CT (observed/expected number of cycles < 1), RT and HT (observed/expected dose < 1) and one year overall survival. Multivariate logistic regression and Cox -Proportional Hazard Model were used to estimate predictors of noncompletion treatments and survival.

Results

Mean age was 79.2 years (±5.4) years and 224 patients (53.2%) were women.190 (45. 1%) had gastro-intestinal, 109 (25.9%) gynaecologic and 97 (23%) genitor-urinary primary tumors.192 (45.6%) had metastatic disease. 76 (33.8%) received platinum-based therapy. • Rate of noncompletion was 39.1 % for CT versus 6.5 %, 3.5 % and 2.4 % for HT, surgery and RT respectively. In multivariate analysis, predictors of noncompletion of CT were: poor performance status (PS ≥ 2) : OR = 2.1, 95 %CI, [1.06-4.17], p = 0.03, (or Activity of Daily Living (ADL): OR 1 point decrease= 1.5, [1.1-2.0], p= 0.024), decreased renal function: OR 1 ml/min decrease Cockcroft clearance = 1.02, [1-1.03],p= 0.009 and living alone :OR = 1.9, [1-3.6], p = 0.05. One year rate of mortality was 26.2 %. Independant prognostic factors for survival were noncompletion of CT: HR = 3.6, [2.2-6], p < 0.0001, a poor functional status (ADL HR 1 point decrease =1.5, [1.3-1.9], p < 0.0001, metastatic disease:.HR = 3.3, [1.7-6.3], p < 0.0001 and malnutrition: HR = 2.6, [1.6-4.4], p < 0.0001.

Conclusion

In the elderly with solid tumors, noncompletion of CT was common whereas HT, RT and surgery were not. Predictors of noncompletion of CT are poor functional status, decreased renal function and living alone. Noncompletion of CT is an independent prognostic factor for survival.

Disclosure

All authors have declared no conflicts of interest.