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A B S T R A C T S

S107

prior to the MDT, at which clinicians, blinded to the G8 result,

made a recommendation on appropriate treatment, including

referral for CGA if considered advisable. Patients considered

vulnerable (G8 score <14) were also to be referred for CGA.

Subsequent treatment and outcomes were recorded.

Results:

Over 6 months, 35 patients were recruited, median

age 74 (range 65-93). Seventeen (49%) patients were assessed

as vulnerable by the G8 score, including 7 (20%) whom the

MDT referred for CGA. Seven with G8 scores <14 did not

receive a CGA. Thirty (85.7%) underwent curative-intent

treatment, including 6 of 7 who had CGA. Of 10 vulnerable

patients who did not have CGA, 60% received curative-intent

treatment. Mean length of post-operative stay was 12.2 vs.

6.5 days in patients deemed vulnerable or fit by G8 scores,

respectively (p=0.46); completion rate of radical radiotherapy

was 75% vs. 100% in each group, respectively (p=0.13). Mean

post-operative length of stay in vulnerable patients who

underwent a CGA was 6.2 days vs. 17.3 days in those who

were not referred (p=0.79).

Conclusion:

The G8 tool identified twice the number of

patients as vulnerable compared to theMDT.There was a trend

towards longer post-operative stay and lower radiotherapy

completion rates in patients deemed vulnerable by G8 scores.

Disclosure of interest:

None declared

Keywords:

G8, comprehensive geriatric assessment, head

and neck cancer

P120

ALTERATION OF DOMAINS IN COMPREHENSIVE GERIATRIC

ASSESSMENTS AND SURVIVAL IN A FRENCH MULTICENTER

COHORT OF ELDERLY PATIENTS WITH CANCER

M. Frasca

1,2,

*, P. Soubeyran

3,4,5,6

, C. Bellera

1,7

, M. Rainfray

1,2

,

S. Mathoulin-Pelissier

1,4,7

and French ONCODAGE group

1

Inserm U1219 Research Center, Epicene Team (Epidemiology of

Cancer and Environmental Exposure),

2

CHU Bordeaux,

3

INSERM

U1218 Research Unit,

4

Bordeaux University,

5

French National

Cancer Institute (INCa) Integrated Cancer Research Site (SIRIC),

Institut Bergonié,

6

Department of Medical Oncology, Institut

Bergonié, Comprehensive Cancer Center,

7

Clinical Research and

Clinical Epidemiology Unit, Institut Bergonié, Comprehensive

Cancer Centre, Bordeaux, France

Introduction:

More than 200,000 elderly patients are

treated for cancer every year in France. Major risks faced by

these patients include death and institutionalization. Frailty,

a group of disorders related to age, is predictive of these risks.

Frail elderly patients are usually detected by a comprehensive

geriatric assessment (CGA) that evaluates several domains

including nutritional status, autonomy, mobility, cognitive

and psychological status, and comorbidities.

Objectives:

This work aimed at estimating the association

between altered domains of CGA at cancer diagnosis and

overall survival (OS) of elderly patients with cancer. The

secondary objective was to estimate the association with

institutionalization at five years.

Methods:

From 2008 to 2010, cancer patients were

consecutively included in a multicenter study (ONCODAGE) at

diagnosis.Twenty-three French centers participated. CGAwere

performed at baseline and included seven questionnaires:

mini nutritional assessment (MNA), activities of daily living

(ADL), instrumental ADL (IADL), timed get up and go (TUG),

mini-mental state examination (MMSE), geriatric depression

scale 15 (GDS-15) and cumulative illness rating scale (CIRS-G).

Survival and data on living place were collected at five years.

Sample baseline characteristics were described. Median

survival was estimated using Kaplan-Meier survival curves.

Relative risk of death was estimated for each CGA’s domain

using seven multivariate Cox models (one per questionnaire).

For institutionalization, logistic models were used. Each

time, adjustment factors were selected using directed acyclic

graphs.

Results:

A total of 1264 patients were analyzed for OS

(mean age: 78 years, women: 70%, breast cancer: 55%, altered

autonomy: 42%, altered nutritional status: 41%). Median

follow-up was 5.2 years and 446 patients died during the

study period. Institutionalization was evaluated in 366

patients (mean age: 76 years, women: 80%, breast cancer:

72%, altered autonomy: 25%, altered nutritional status: 26%).

All CGA domains, if altered, were associated with a decreased

OS. For several domains, these effects were only statistically

significant during a certain period or for some patient

categories. Altered nutritional status was associated with

decreased OS at one and three years (HR=2.97, p<0.01 and

HR=2.24, p<0.01, respectively) but not at five years. Altered

autonomy and mobility were associated with a lower survival

for younger patients, and women when assessed by IADL

(ADL, IADL, TUG: HR=1.54, p<0.01; HR=1.46, p=0.02; HR=2.19,

p<0.01, respectively). Altered cognitive status and a decreased

OS were only associated for the most educated patients

(primary, secondary and graduated degrees: HR=1.84, p<0.01;

HR=2.67, p=0.01; HR=3.89, p=0.03, respectively). Psychological

status and more than four comorbidities were associated for

all patients (GDS-15: HR=1.38, p<0.01; CIRS-G: HR=1.64, p<0.01).

Only altered autonomy assessed by IADL and cognitive status

were associated with more institutionalizations (OR=8.90,

p<0.01; OR=6.30, p=0.02, respectively).

Conclusion:

These results confirm the interest of CGA

for elderly people with cancer. Altered domains of CGA

were associated with a decreased five-year OS. Awareness

of the importance of these factors depending on patients’

characteristics can help provide appropriate supportive cares.

Disclosure of interest:

None declared

Keywords:

Cancer, comprehensive geriatric assessment,

elderly patient, institutionalization, survival