Abstract 1861P
Background
The elderly population heterogeneity in terms of comorbidities and functional status may explain the difficulty in establishing management recommendations. The Comprehensive Geriatric Assessment (CGA) is a multidimensional assessment of general health status. The CGA is a tool used to discriminate between different groups of patients with different frailty levels. Our objective was to assess the CGA influence in therapeutic decisions and to identify the CGA parameters associated with therapeutic modifications.
Methods
AA prospective study was conducted in elderly cancer patients. A comprehensive geriatric assessment has been performed. Treatment decision was taken initially by the staff of oncologists according to the guidelines without geriatric assessment and secondly according to the results of CGA. The decision modification was either to intensify the treatment or to reduce it. An univariate and multivariate analysis were used to identify factors associated with changes in the cancer treatment.
Results
200 patients were included. Mean age was 74.3 ± 6.2 years [65-93]. Colorectal cancer (33.5%) and lung cancer (31.5%) were the most common localization. 110 patients had ≥ 1 comorbidity and 142 were taking <3 medications. 45.5% were in good performance status (PS 1). G8 was <14 in 45.5%, 52 % were dependant for 1 to 3 activities of daily living (ADL). 31.5 % were dependant for 3 to 4 activities of instrumental daily living (IADL). Half of patients had impaired mobility; 28.5 % presented medium cognitive impairment. 47.5% presented a poor nutritional status. Patients were fit (39%), vulnerables (45.5%) and frail (15.5%).After CGA, the chemotherapy treatment plan was modified for 49 patients, intensity treatment was increase in 31 patients and decrease in 18 patients.By univariate analysis, treatment changes were associated with age (p=0.007) and dependency for one or more activities of daily living ADL (p=0.02). Multivariate analysis showed that only the age ≥ 75 years had a statistically significant p=0.04 (OR: 0.49 IC [0.25-0.98]).
Conclusions
The geriatric assessment has an impact on the therapeutic decision of old patients. Changes in treatment decisions were correlated with age and ADL dependence.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Miraoui Dalila.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.