Abstract 1605P
Background
The incidence of cancer among older people is increasing, with poor survival. We assessed the prognostic value of comorbidities in older patients with cancer.
Methods
We analyzed all older patients (aged 70 or over) with colorectal, breast, prostate or lung cancer included in the prospective ELCAPA cohort. The Cumulative Illness Rating Scale - Geriatrics (CIRS-G) score was used to assess comorbidities at the baseline geriatric assessment. The primary endpoint was overall survival (OS) at 3 months, 1 year, and 3 years. The adjusted difference in the restricted mean survival time (RMST) was used to assess the strength of the relationship between comorbidity and survival.
Results
Of the 1551 patients included, 502 (32%), 575 (38%), 283 (18%), and 191 (12%) had colorectal, breast, prostate or lung cancer, respectively, and 50% had metastatic disease. Hypertension, kidney failure, and cognitive impairment were the most common comorbidities (in 67%, 38%, and 29% of the patients, respectively). A CIRS-G score >17, ≥2 severe comorbidities, >7 comorbidities, and heart/respiratory failure were independently associated with shorter OS. The greatest effect size was observed for CIRS-G >17 (versus CIRS-G <11): at 3 years, the adjusted differences in the RMST (95% confidence interval) were -199 days (-214, -53) for colorectal cancer, -278 (-406, -149) for breast cancer, -246 (-385, -108) for prostate cancer and -187 (-326, -49) for lung cancer (P <0.05 for all).
Conclusions
The type, number and severity of comorbidities were independently associated with shorter OS. The strength of this association depended on the cancer site. A cut-off of 17 for the total CIRS-G score can be used in clinical practice.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
This work was supported by a grant (#RINC4) from the French National Cancer Institute (Institut National du Cancer, INCa), Canceropôle Ile-de-France and Gerontopôle Ile-de-France (Gérond’if).
Disclosure
J. Gligorov: Financial Interests, Personal, Invited Speaker, Symposia: Astra Zeneca, Exact Science, Lilly, Amgen; Financial Interests, Personal, Advisory Board, Expert opinion meeting: Daiichi; Financial Interests, Personal, Invited Speaker, Expert opinion meeting: Eisai; Financial Interests, Personal, Advisory Board, Expert meeting: Merck; Financial Interests, Personal, Expert meetings, educational programs and speaker at symposia: Novartis; Financial Interests, Personal, Expert meeting, educational programs and speaker at symposia: Pfizer; Financial Interests, Personal, Advisory Board, Expert opinion: Pierre Fabre; Financial Interests, Personal, Expert opinion meetings, educational programs and speaker at symposia: Roche Genentech; Financial Interests, Personal, Expert opinion meeting, speaker at symposia: Seagen; Financial Interests, Personal, Invited Speaker, Medical Education industry: AGM, Kephren, Decision Santé; Non-Financial Interests, Leadership Role: Nice St Paul de Vence cours; Non-Financial Interests, Member: ABC Global Alliance; Non-Financial Interests, Part of some educational programs: ESO; Non-Financial Interests, Leadership Role, Association for Oncology improvement in Mediterranean countries: AROMe. All other authors have declared no conflicts of interest.