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
4526 - Long-term outcome of neoadjuvant tyrosine kinase inhibitors (TKI) in locally advanced dermatofibrosarcoma protuberans (DFSP)
Presenter: Jessica Beaziz
Session: Poster Display session 1
Resources:
Abstract
1214 - Neo-adjuvant (NA) Imatinib for gastrointestinal stromal tumours (GISTs): What is the optimal length of treatment?
Presenter: Tom Wilson
Session: Poster Display session 1
Resources:
Abstract
2690 - Gastrointestinal Stromal Tumours (GIST) in adolescents and young adults (AYA)
Presenter: Nikki Ijzerman
Session: Poster Display session 1
Resources:
Abstract
4558 - Radiomics improves response evaluation for desmoid tumors treated with chemotherapy
Presenter: Amandine Crombe
Session: Poster Display session 1
Resources:
Abstract
2751 - Radiomics of gastrointestinal stromal tumors; risk classification based on computed tomography images – a pilot study
Presenter: Milea Timbergen
Session: Poster Display session 1
Resources:
Abstract
2737 - Differentiating well-differentiated liposarcomas from lipomas using a radiomics approach
Presenter: Melissa Vos
Session: Poster Display session 1
Resources:
Abstract
1282 - The immune landscape of chondrosarcoma reveals an anti inflammatory environment
Presenter: Iseulys Richert
Session: Poster Display session 1
Resources:
Abstract
1572 - Impact of Immunotherapy and Targeted Therapy on Tumor Growth Rate in Sarcoma
Presenter: Esmail Al-ezzi
Session: Poster Display session 1
Resources:
Abstract
3414 - DNA methylation profiles of angiosarcoma subtypes.
Presenter: Marije Weidema
Session: Poster Display session 1
Resources:
Abstract
3411 - Prognostic significance of circulating PD-1, PD-L1, pan-BTN3As and BTN3A1 in patients with metastatic gastrointestinal stromal tumors (mGISTs)
Presenter: Daniele Fanale
Session: Poster Display session 1
Resources:
Abstract