Abstract 3097
Background
Cancer is a disease of elderly, however data from evidence-based-medicine are missing for therapeutic decision in this population. One of the main issues is to avoid over- and undertreatment situations. Cancer treatment decision in the elderly mainly relies on the Geriatric Assessment (GA) recommended by the International Society of Geriatric Oncology (SIOG). Based on the GA, predictive scores of early death have been developed but they remain difficult to implement in daily oncological practice. In this study, we proposed a simple score with five clinical items to predict 6-month mortality risk in older cancer patients, to guide therapeutic decision.
Methods
A total of 603 patients aged 65 and over were prospectively included in registry in a two-center cohort study that started in November 2013. The whole cohort was divided in a development subset (n = 439), and a validation subset (n = 164) We created a multivariate Cox proportional hazard model with a selection process based on the lowest Akaïke Information Criteria. A beta-coefficient point-based scoring system was used to weight each predictor. Discrimination used the survival Harrel’s C index with 95% CI. Clinical impact was assessed using decision curves.
Results
The mean age was 81.2 ± 6.1 years. Most patients were women and had locally advanced (38%) or metastatic cancers (45%). Colorectal, breast and lung cancers were the most common types. At 6 months, the mortality rate was 17.5%. The score we developed, namely GAIT-SPEED, included five clinical variables: unintentional loss weight of at least 5% of the previous year, slow gait speed < 0.8 m/s, cancer site, cancer extension, and exclusive supportive care decision. We identified 4 increasing risk group (low, medium, high and very-high), ranged from 2% to 61%. The score was well calibrated, and discrimination was good with a Harrel’s C index of 0.75 [0.69-0.81]. Up to 14% of risk of early death, decision curves encourages for a cancer-treatment.
Conclusions
In this study, we developed and validated a simple score easy to implement in daily oncological practice, to predict early death in older cancer patients and guide oncologists in their treatment decision.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Frédéric Pamoukdjian.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4658 - Patient-reported outcomes associated with switching to rivaroxaban for the treatment of venous thromboembolism (VTE) in patients with active cancer
Presenter: Alexander Cohen
Session: Poster Display session 1
Resources:
Abstract
5638 - Incidence of Vascular Thromboembolism Events in Cancer Patients Receiving Immunotherapy: A Single Institution Experience.
Presenter: Laura Gutiérrez Sainz
Session: Poster Display session 1
Resources:
Abstract
5182 - High Incidence of Venous Thromboembolic Events (VTE) in Patients with Diffuse Large B-Cell Lymphoma.
Presenter: Alaa Abufara
Session: Poster Display session 1
Resources:
Abstract
1504 - Weight Loss over Time in Non-Small Cell Lung Cancer: Results from a Landmark Analysis of 800+ Prospectively-Treated Patients
Presenter: Jennifer Le-rademacher
Session: Poster Display session 1
Resources:
Abstract
3972 - The prognostic significance of preoperative nutritional status in resected pancreatic ductal adenocarcinoma (PDAC).
Presenter: Salvatore Paiella
Session: Poster Display session 1
Resources:
Abstract
2313 - Impact of Timing and Technique of Gastrostomy Placement on the Outcome of Patients (pts) with Head and Neck Cancer (HNC)
Presenter: M Julia Lostes Bardaji
Session: Poster Display session 1
Resources:
Abstract
5219 - Clinical & nutritional determinants of quality of life in patients with incurable cancer
Presenter: Louise Daly
Session: Poster Display session 1
Resources:
Abstract
4075 - Loss of skeletal muscle mass during palliative chemotherapy is a poor prognostic factor in patients with advanced gastric cancer
Presenter: In Gyu Hwang
Session: Poster Display session 1
Resources:
Abstract
4159 - Impact of nutritional derangement on treatment outcome in advanced non-small-cell lung cancer (A-NSCLC) patients (pts).
Presenter: Ilaria Trestini
Session: Poster Display session 1
Resources:
Abstract
1210 - Sarcopenia and pretreatment anemia as prognostic factors for patients with localized muscle invasive bladder cancer treated by neoadjuvant chemotherapy and radical cystectomy
Presenter: Emilien Billon
Session: Poster Display session 1
Resources:
Abstract