Abstract 1863P
Background
Seventy percent of cancer types are diagnosed in people over 65 years old. These data suggest a great challenge in the management of these patients (pts), and the optimisation of treatment in this population is a priority. As the age of patients progresses, best supportive care (BSC) measures become a very valid option, and systemic treatments (STs) are more controversial. Accordingly, the aim of this study is to analyse the impact of systemic treatment compared to BSC regarding survival in cancer pts over 80.
Methods
A retrospective study of pts over 80 diagnosed with cancer between 2016 and 2018 was conducted at the University Healthcare Complex of Salamanca. Pts were divided into two cohorts according to the therapeutic strategy received, BSC or STs. Survival analysis was performed with the Kaplan−Meier and Cox regression method using SPSS v. 26 software. Statistical significance was established by p <0.01.
Results
A total of 398 pts were included: 213 (53.5%) men and 185 (46.5%) women. The median age was 87 years. In the group that received BSC (180/398, 45.2%), the median overall survival (OS) was 3 months versus 55 months in pts who received STs (218/398, 54.8%) (HR = 0.12 [95% CI 0.089-0.162]; p <0.001). One hundred and ninety-six pts (49.2%) were diagnosed in the early stage (ES) or locally advanced (LA), and 202 pts (50.8%) were diagnosed at the advanced stage. When the two cohorts were analysed considering the stages, the OS of pts with ES or LA who received BSC compared to STs was 5 months versus 60 months (HR = 0.118 [95% CI 0.068-0.207]; p <0.001). In advanced stages, the OS for BSC versus STs was 3 months versus 22 months (HR = 0.312 [95% CI 0.206-0.474]; p <0.001), respectively. Within STs, chemotherapy in pts with advanced stages demonstrated an OS of 15 months versus 3 months in the BSC group (HR = 0.329 [95% CI 0.157-0.690]; p = 0.001).
Conclusions
Based on the results of our study, STs in the elderly population are associated with a significant increase in survival compared to BSC alone. A multidisciplinary assessment with geriatric counselling is essential for the initiation of cancer treatments in elderly pts. Therefore, more studies on cancer treatments are needed in this group of pts.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.