Abstract 1699P
Background
Older adults aged ≥ 65 make up 40% of all patients diagnosed with cancer in Singapore. However, many oncologists are unaware of geriatric oncology tools like the comprehensive geriatric assessment (CGA) and the role of surgical prehabilitation prior to cancer surgery. A Geriatric Oncology Longitudinal End to eNd (GOLDEN) program was introduced in the National University Cancer Institute, Singapore (NCIS) where older cancer patients are seen prior to their cancer surgery for prehabilitation, and/or prior to commencing systemic therapy.
Methods
All patients seen in the NCIS outpatient clinic aged ≥65 were screened with a G8 and those who scored <14 were suggested for enrolment in the GOLDEN program. A CGA would be done for all patients on entry to the program. A multidisciplinary team then recommended interventions for the patients based on the CGA findings and patients going for cancer surgery will be enrolled for prehabilitation. The GOLDEN program objectives were i) Timely screening of patients, ii) Tailored upstream interventions for patients, iii) Improvement in patients’ quality of life (QoL) and reduction in caregivers’ stress and iv) reduction in the average length of perioperative stay and readmission rates.
Results
793 older cancer patients were screened over 24 months at an interim analysis. 68% of the patients (n=544) were enrolled in GOLDEN. 513 patients were identified to require upstream interventions and 92% (N=471) received the interventions. 31% of patients who received interventions had an improvement in their QoL and 29% of caregivers had a reduction in their Zarit Burden interview score. For patients undergoing cancer surgery, the average length of stay was 10 days for patients in GOLDEN and 15 days for patients not in the program. The % of cases with no readmission within 30 days was 94% for the patients in GOLDEN and 89% for patients not in the program.
Conclusions
Early identification and tailored interventions based on a CGA will improve the QoL of some elderly cancer patients and reduce their caregivers’ stress. In addition, there are improvements in surgical outcomes when they undergo surgical prehabilitation in the GOLDEN program. We will continue to accrue more patients and evaluate our outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Jurong Health Fund.
Disclosure
All authors have declared no conflicts of interest.