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
2490 - Gender effect on the pharmacokinetics (PK) and pharmacodynamics (PD) of anamorelin (ANAM) in healthy volunteers and cancer patients with cachexia
Presenter: Stein Kaasa
Session: Poster Display session 1
Resources:
Abstract
4294 - The Patient Voice: An Irish Survey of Nutrition Attitudes & Access to Dietetic Care Throughout the Cancer Journey
Presenter: Erin Stella Sullivan
Session: Poster Display session 1
Resources:
Abstract
1925 - Homcology: home chemotherapy delivery in a simultaneous care project for frail advanced cancer patients
Presenter: Claudio Chini
Session: Poster Display session 1
Resources:
Abstract
4701 - Treatment-related adverse events and tolerability in patients with advanced non-squamous non-small cell lung cancer treated with first-line checkpoint inhibitors in combination with chemotherapy
Presenter: Ruth D'cunha
Session: Poster Display session 1
Resources:
Abstract
2985 - Clinical utility of a systematic toxicity assessment form (STAF) in patients with breast cancer receiving adjuvant or neoadjuvant therapy.
Presenter: Jwa Hoon Kim
Session: Poster Display session 1
Resources:
Abstract
2358 - Physicians’ satisfaction with Health-related quality of life (HRQoL) assessment in daily clinical practice using electronic patient-reported outcome (ePRO) for cancer patients.
Presenter: Guillaume Mouillet
Session: Poster Display session 1
Resources:
Abstract
5172 - Predictors of Survival in Patients with Incurable Cancer
Presenter: Erin Stella Sullivan
Session: Poster Display session 1
Resources:
Abstract
2281 - Patients and Physicians' Satisfaction with Telemedicine (TM) in Cancer Care and Factors that Correlate with a Positive Patient’s Experience
Presenter: Hurria Gondal
Session: Poster Display session 1
Resources:
Abstract
2193 - Adherence to ESMO 2014 guidelines on bone-targeting agent (BTA) initiation for breast and prostate cancer patients: real-world insights from practicing European physicians
Presenter: Alex Rider
Session: Poster Display session 1
Resources:
Abstract
2200 - Use of skeletal-related events preventive agents in patients with solid tumours and bone metastases in central Denmark
Presenter: Anders Boysen
Session: Poster Display session 1
Resources:
Abstract