Abstract 1705P
Background
The patient's suitability for systemic treatment is often decided based on the Eastern Co-operative Oncology Group (ECOG) performance status (PS). However, even in patients with a good PS (0/1), a geriatric assessment (GA) contributes tangible importance to the functional assessment in older cancer patients.
Methods
This was an observational retrospective study between 2018 and 2021 in the Geriatric Oncology Clinic at Tata Memorial Hospital, Mumbai, India. The study was approved by the Institutional Ethics Committee (IEC-III; Project No. 900596) and registered at the Clinical Trials Registry of India (CTRI/2020/04/024675). Written informed consent was obtained in the prospective part of the study. Patients aged ≥60 years with solid tumors were evaluated. ECOG PS was assessed in all the patients and a GA was performed. The patients were evaluated for abnormalities in five principal domains including functions, comorbidities, nutrition, cognition, and psychological issues. The distribution of these abnormalities was analyzed across the four groups (ECOG PS 0-3).
Results
We included 523 patients, median age 70 years, (IQR, 65 to 74); 78% of patients were males. The most common malignancies were lung (40%) and gastrointestinal (33%). Of the 523 patients, 8% patients had PS 0, 53% had PS 1, 26% had PS 2 and 13% had PS 3. Nutritional abnormalities were noted in 74%, comorbidities in 82%, functional limitations in 52%, cognitive impairment in 16% and psychological issues in 7% patients. 97% of patients had at least one abnormal domain in the GA (Table). Table: 1705P
| ECOG PS (n=523) | Patients with ≥1 abnormal domain (n=509) (%) | Median No. of abnormal domains (IQR) | No. of patients with abnormal nutrition (%) | No. of patients with abnormal functions (%) | No. of patients with co-morbidities (%) | No. of patients with impaired cognition (%) | No. of patients with psychological issues (%) |
| 0 (43) | 40 (93) | 2 (1-2) | 22 (51) | 9 (21) | 33 (77) | 0 | 0 |
| 1 (280) | 270 (96) | 2 (1-3) | 194 (69) | 109 (39) | 224 (80) | 30 (11) | 9 (3) |
| 2 (134) | 133 (99) | 3 (2-3) | 115 (86) | 94 (70) | 115 (86) | 36 (27) | 14 (11) |
| 3 (66) | 66 (100) | 3 (3-4) | 56 (85) | 59 (89) | 59 (89) | 17 (26) | 13 (20) |
Conclusions
The proportion of abnormal domains increases with an increase in the ECOG PS. Over 90% of patients with PS 0/1, who are considered to be fit, had at least an abnormal domain on the GA. Hence, a GA along with PS is crucial in identifying these additional vulnerabilities to optimally care for older patients with cancer.
Clinical trial identification
Institutional Ethics Committee (IEC-III; Project No. 900596), Clinical Trials Registry of India (CTRI/2020/04/024675).
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
V. Noronha: Financial Interests, Institutional, Research Grant: Amgen; Financial Interests, Institutional, Research Grant: Sanofi India Ltd; Financial Interests, Institutional, Research Grant: Dr. Reddy’s Laboratories Inc; Financial Interests, Institutional, Research Grant: Intas Pharmaceuticals; Financial Interests, Institutional, Research Grant: AstraZeneca Pharma India Ltd. K. Prabhash: Financial Interests, Institutional, Research Grant: Dr. Reddy’s Laboratories Inc; Financial Interests, Institutional, Research Grant: Fresenius Kabi India Pvt Ltd; Financial Interests, Institutional, Research Grant: Alkem Laboratories; Financial Interests, Institutional, Research Grant: Natco Pharma Ltd; Financial Interests, Institutional, Research Grant: BDR Pharmaceuticals Intl Pvt Ltd; Financial Interests, Institutional, Research Grant: Roche Holding AG. All other authors have declared no conflicts of interest.