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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.


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


(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.


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.



[1] Puts MT. Ann Oncol. 2014 Feb;25 (2):307-15.

[2] Balducci L, Yates J. Oncology (Williston Park) 2000;14:221-


[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


Functional decline, geriatric oncology, survival




A. Luciani


*, C. Careri


, S. Caldiera


, M. Violati


, D. Ferrari



P. Foa



Medical Oncology,


Ospedale S. Paolo, Milano, Italy


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.



of elderly patients that received an oncological management

after a cancer diagnosis in medicine departments


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.


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.


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


Elderly, frailty, inpatients