545P - Geriatric assessment predicts survival and competing mortality in colorectal cancer elderly patients. Can it help in adjuvant therapy decision?

Date 08 October 2016
Event ESMO 2016 Congress
Session Poster Display
Topics Colon and Rectal Cancer
Presenter Maite Antonio
Citation Annals of Oncology (2016) 27 (6): 149-206. 10.1093/annonc/mdw370
Authors M. Antonio1, J. Saldaña1, A. Carmona-Bayonas2, V. Navarro3, C. Tebe4, F. Formiga5, R. Salazar1, J. Borras6
  • 1Medical Oncology, Institut Catala de Oncologia, 08907 - L'Hospitalet de Llobregat, Barcelona/ES
  • 2Medical Oncology, Hospital Universitario Morales Meseguer, Murcia/ES
  • 3Clinical Research Unit, Institut Català d'Oncologia Hospital Duran i Reynals, 08907 - Barcelona/ES
  • 4Biostatistics, IDIBELL, L'Hospitalet de Llobregat, Barcelona/ES
  • 5Internal Medicine, Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona/ES
  • 6Cancer Strategy, Institut Català d'Oncologia Hospital Duran i Reynals, 08907 - Barcelona/ES

Abstract

Background

The selection of elderly patients with colorectal cancer (CCR) for adjuvant therapy remains a challenge. The main critical issue is to estimate if the patient risk of dying from non-cancer-related (NCR) causes prelude cancer events.The aim of this paper is to evaluate whether an abbreviated Comprehensive Geriatric Assessment (aCGA) could predict survival and cancer mortality in high-risk resected CCR elderly patients candidates to adjuvant therapy.

Methods

195 consecutive patients aged ≥75 with high-risk stage II and III CCR were prospectively enrolled. All patients underwent aCGA, which included comorbidity, polypharmacy, functional status, geriatric syndromes, mood, cognition and social support. According to aCGA results, patients were classified as: “fit” (F), “medium fit” (MF) and “unfit” (UF) to receive standard therapy, adjusted treatment and best support care, respectively. Patients were followed-up for at least 6 months or until death, and toxicity, survival and the cause of death were recorded. A competing risk approach was used to evaluated causes of death by oncogeriatric classification.

Results

85 (44%) patients were classified as F, 56 (29%) as MF and 54 (27%) as UF. The 5-year survival rate was 74%, 52% and 27 % in the F, MF and UF, respectively. At the end of the follow-up, 61 (31%) patients had died (14 F, 16 MF and 31UF). The causes of death were cancer progression (CP), NCR, and unknown reason, in 54%, 46% and 1%, respectively; there were not toxicity-related deaths Overall population was more likely to die of CP rather than of NCR cause. However, stratifying by oncogeriatric categories, at the end of 5 year following surgery, 42% F, 52% MF and 15% UF patients died because of CP, while

Conclusions

aCGA shown efficacy in predicting survival and competing risk of death in elderly patients with high-risk stage II and III CRC who underwent curative resection. aCGA is useful to shape adjuvant decision-making.

Clinical trial identification

Legal entity responsible for the study

Institut Català d'Oncologia-Hospital Duran i Reynals

Funding

Institut Català d'Oncologia-Hospital Duran i Reynals

Disclosure

All authors have declared no conflicts of interest.