A B S T R A C T S
pathologies. These include neoplasms in patients over 65
that account for 60% of new cancer cases and 70% of related
deaths in Western Europe and the United States.
Geriatric Oncology is a discipline that embraces 3 key
aspects of our demographic and health needs: the ageing of
the population, the rising incidence of cancer in older patients
and the complexity of cancer management in the elderly.
A retrospective assessment of the results
obtained in the first year after the implementation of a
Geriatric Oncology Unit (June 2014 to October 2015).
The model of Geriatric Oncology at Fundació
Althaia is one of integration that includes the collaboration of
a physician in internal medicine specially trained in geriatrics
in the committees for tumours .
Patients over 80 years are assessed in a specific consulting
room (within 4 days), where they undergo a comprehensive
geriatric assessment (CGA). Depending on the CGA results,
patients are assigned to one of the following 4 groups:
Type 1: Competent, “fit” for oncospecific treatment.
Candidates for standard treatment.
Type 2: Vulnerable. Candidates for oncospecific treatment
with geriatric intervention.
Type 3: Fragile. Candidates for tailor-made treatment.
Type 4: Terminal. Candidate for symptomatic treatment.
Assessment of the results of the oncogeriatric
intervention in patients from the committee for urological
tumours. Twenty-three patients were assessed, 15 of which
presented infiltrating gallbladder tumours (13 stage T2-
4N0M0, 2 BCG refractory in situ carcinoma), 4 prostate
neoplasms (located tumour-high risk, candidates for radical
RT), 4 renal tumours (stage T3 N0-1 M0-1, candidates for
radical nephrectomy) . All patients were candidates for radical
treatment. Mean age was 79.7 years. The classification after
CGA was: 47.8% of patients fit, 17.4% vulnerable, 26.1% fragile
and 8.7% terminal illness. Treatment plan was not changed
pre- or post- CGA in 43.4% of patients. However, intensity of
treatment was adjusted in 56.6%.
The introduction of a geriatric oncology
assessment in committees for tumours has lead to an
improvement in the selection of patients over the age of 80
candidates for radical surgical treatment.
Disclosure of interest:
TRANS SECTORAL CARE OF GERIATRIC CANCER PATIENTS
BASED ON COMPREHENSIVE GERIATRIC ASSESSMENT AND
PATIENT-REPORTED QUALITY OF LIFE
*, S. Boese
, K. Lampe
, K. Jordan
, E. Fiedler
, D. Vordermark
Institute of Health and Nursing Sciences, Martin Luther University
Department of Radiation Oncology,
of Hematology and Oncology,
Department of Dermatology,
University Hospital Halle Saale, Halle (Saale),
Centre, Charite - Universitätsmedizin Berlin, Berlin, Germany
For elderly cancer patients the maintenance
of independence, functionality and health related quality
of life (HRQOL) is of great importance. Treatment decisions
and transsectoral care are often complicated by the number
and severity of comorbidities reduced physical and cognitive
functioning and the organization of care at home. Therefore,
the identification of relevant risk factors by comprehensive
geriatric assessment (CGA) is recommended prior to cancer
Aiming to maintain HRQOL of geriatric cancer
patients we developed an interdisciplinary care program based
on comprehensive geriatric assessment (CGA) and patient
reported HRQOL comprising tailored supportive measures and
telephone based counselling during 6 months aftercare.
Pilot testing of the intervention took place in
three centres at the University Hospital Halle Saale to examine
feasibility, acceptance and potential benefit. Oncologic
70 years with at least one comorbidity and/or one
functional impairment, receiving curative or palliative care
were eligible. Primary endpoint is HRQOL (EORTC QLQ-C30,
ELD14), measured at admission and 6 month-follow-up.
Secondary endpoints are symptom burden, unscheduled
readmissions and overall survival.
Out of n=226 eligible patients n=100 participated
(44%), mean age: 76.3 years (SD 4.8), 47% female. On average
participants had 5 comorbidities (SD 2.8, min. 0, max. 15)
and took 8 medications (SD 3.6, min. 0, max. 15). Follow-up
will be completed by July 2016. Individualized supportive
care was triggered by summarized individual results that
were presented to the treating physicians (e.g. malnutrition,
reduced HRQOL, reduced physical functioning, high
symptom-intensity and depression). Preliminary analyses for
the primary endpoint global HRQOL (n=46) showed clinical
relevant improvement of HRQOL (
10 pts.) for 35%, no change
for 41% and worsening for 24%. Concurrent with worsening of
global HRQOL we found a deterioration of physical function,
mobility and fatigue (EORTC QLQ C30). Comparisons of
professional and patients’ self-assessments including HRQOL
and subgroup analyses describing correlations of risk profiles
with HRQOL and survival will be presented.
First results show feasibility and potential use-
fulness of the combination of CGA and HRQOL to complement
standard assessments and to decide on individualized
therapeutic measures. The nurse led telephone based after-
care was well accepted.
Disclosure of interest:
H. Schmidt: None declared, S. Boese:
None declared, K. Lampe: None declared, K. Jordan Consultant