117 / 154
A B S T R A C T S
S87
outcomes. Sample size was estimated in 180 assuming a 20%
follow up loss, 15% incident functional decline, Alfa error=0.05
and Beta error=0.20. Statistical analysis:Fisher exact test
to categorical variables and t-Student or Mann-Whitney to
interval variables. To determine the factors associated with
functional decline Stepwise backward logistic regression
model was used and the survival analysis was made with Cox
Proportional-Hazard Regression with forced entry.
Results:
286 patients were enrolled and 60 were excluded.
Mean age was 81 years (SD 6.46). Gastrointestinal cancer
was the most prevalent (n=56) followed by breast cancer
(n=53). 74.8% underwent surgery, 38.7% chemotherapy and
31.9% radiotherapy. Of the 226 patients, 147 survived and 22
had missing data. Among the 147 survivors, 38 developed
functional decline.
In the functional decline analysis (n=147) mean Mini-
Mental Exam Score was 21.03 (SD 6.29), hang grip strength
was 26.01kg/m
2
(SD 7.62) and gait speed 0.49m/s. As an
independent variable, patients that underwent chemotherapy
had a 4-fold risk of functional decline (OR=4.29 CI95% 1.31-
14.06).Advanced age was associated with increased functional
decline (12% risk increase for each additional year). Analyzing
the CGA variables through regression models, none of them
was associated with functional decline.
In the survival analysis (n=226) the median follow-up
was 357 days and survival was 73.7%. After adjustments for
oncologic, social and demographics variables, none of the
CGA variables were associated with survival.
Conclusion:
In this sample, the addition CGA did not
enhance the prediction of 1 year functional decline and
survival. Limitations of the study that might have contributed
are the excessive amount of missing data (n=125) for the
primary outcome, which reduced the power of the study. The
functional decline was analyzed only on the survivor group,
tumor site was not included in the multivariate analysis and
functional variables (basic and instrumental activities of daily
living and Karnofsky Performance Scale) were not considered
on the regression models in order to avoid multicollinearity.
References
:
[1] Puts MT. Ann Oncol. 2014 Feb;25 (2):307-15.
[2] Balducci L, Yates J. Oncology (Williston Park) 2000;14:221-
227.
[3] Hurria A, Browner IS, Cohen HJ, et al. S J Natl Compr Cancer
Netw 2012;10(2):162-209.
Disclosure of interest:
None declared
Keywords:
Functional decline, geriatric oncology, survival
P085
CLINICAL RELEVANCE OF ONCOLOGICAL DIAGNOSIS IN
FRAIL ELDERLY PATIENTS
A. Luciani
1,
*, C. Careri
2
, S. Caldiera
2
, M. Violati
2
, D. Ferrari
2
,
P. Foa
1
1
Medical Oncology,
2
Ospedale S. Paolo, Milano, Italy
Introduction:
Older patients admitted to the hospital with
an suspect of neoplasm often undergo radiological as well
as bioptic examinations in order to have a cancer diagnosis.
Some of them are referred to an oncological department to
receive cancer treatment. However there is a large amount of
patients that do not receive cancer treatment because of their
clinical status and/or their age.
Objectives:
Theaimofthisstudyistoevaluatetheprevalence
of elderly patients that received an oncological management
after a cancer diagnosis in medicine departments
Methods:
We examined clinical charts of patients with
more than 70 years old admitted to the medicine departments
of our hospital with a suspicious of cancer. The patients had
to have a principal or secondary new cancer diagnosis at the
discharge from the hospital. For all patients we collected the
number and type of comorbidities, number of medications.
Data on type of diagnostic exams, the diagnosis of cancer and
the subsequent destination of the patients were recorded.
A multiple regression analysis was computed in order to
evaluate which clinical elements were significantly associated
with oncological consultations and treatment.
Results:
838 patients with more than 70 years old (mean
79, 70-100 SD 6.2) were evaluated. 451 (54% were male), and
461 (55%) with a metastatic disease. The patients were taken a
mean number of drugs of 7.35 (0-19, SD 3.34) and were affected
by a 4.67 (0-15 SD .15) mean of comorbidities. In 481 (49.9%) of
patients the suspected diagnosis at admission to the hospital
was oncological. 367 (44%) of patients had a complete cancer
diagnostic test while 86% had cancer as principal diagnosis
at the day of the discharge from the hospital. Only 35% (293
pz) were referred to an oncological department. Multiple
regression analyses showe how number of comorbidities
(p 0.004), complete oncological exams (p 000.1), sex male (p
0.0001) and metastatic disease (p 0.001) were the parameters
associated with an oncological treatment or management
after hospital stay.
Conclusion:
Our study showed how only a small proportion
of elderly patients that had a cancer diagnosis received an
oncological management thereafter. This picture is mainly
due to comorbidities and metastatic disease status. Based on
our results there are a lot of patients thata receicved complete
tests but they donot receiv any cancer treatment. This could
be due to the general health status of the patients and
comorbididties and this overdiagnosis produces anxiety on
patients and his family. A better multidisciplinary approach
as well as the condivision of clinical goals with the patients
and his/her family could produce less costs and a better
tailored clinical aproach based on clinical and socio
Disclosure of interest:
None declared
Keywords:
Elderly, frailty, inpatients