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A B S T R A C T S
preoperative impairment of IADL, cognitive impairment
(assessed by MMSE) and gripstrengh test used in fragility
assessment in several studies. Charlson also were predictive
of greater functional loss.
We conclude that the CGA are valuable tool in predicting
functional loss at 1 year and mortality related to cancer
surgery in elderly over 80 years. Although randomized clinical
trials are needed to demonstrate the impact of this inter-
vention in surgical outcomes in medium and long term.
References:
[1] Duron JJ, et al. Risk factors for mortality in major digestive
surgery in the elderly: a multicenter prospective study. Ann
Surg 2011;254(2):375-82.
[2] Liu JJ, Extermann M. Comprehensive geriatric assessment
and its clinical impact in oncology. Clin Geriatr Med
2012;28(1):19-31.
[3] Pope D, Ramesh H, Gennari R, Corsini G, Maffezzini M,
Hoekstra HJ, Mobarak D, Sunouchi K, Stotter A, West C,
Audisio RA. Pre-operative assessment of cancer in the
elderly (PACE): a comprehensive assessment of underlying
characteristics of elderly cancer patients prior to elective
surgery. Surg Oncol 2006;15(4):189-97.
[4] Megan A. Feng et al. Geriatric assessment in surgical
oncology: A systematic review. J Surg Res 2015;193(1):265-
72.
Disclosure of interest:
None declared
Keywords:
Geriatric assessment, perioperative, surgery
P137
THE LONGITUDINAL USE OF GERIATRIC ASSESSMENT IN
AN ONCOLOGY CENTER IN BRAZIL: A PILOT STUDY IN
PATIENTS WITH BREAST CANCER
T. Karnakis
1,
*, R. Kaliks
2
, A. Del Giglio
3
, W. Jacob Filho
4
1
Geriatrics, ICESP,
2
Oncology,
3
Albert Eisntein Hospital,
4
Geriatrics,
University of São Paulo, São Paulo, Brazil
Introduction:
The Cancer and aging are integrally related
and show an inexorable rise in developed and developing
countries. In Brazil, breast cancer is the most common in
women with increased incidence and mortality in the elderly
population.The Comprehensive Geriatric Assessment (CGA) is
an instrument used with insurance by geriatricians to stratify
elderly between different levels of weaknesses and aims to
determine the disabilities for an individual plan of care.
Objectives:
To evaluate the usefulness of CGA and its
applicability as longitudinal monitoring instrument in older
women with breast cancer in Brazil.
Methods:
Cohort study, prospective in elderly women
with
60 years, originated from the public health system,
newly diagnosed breast cancer and they would start cancer
treatment. The patients were followed for two years and
evaluated by the parameters of CGA : Charlson Comorbidity
Index (CCI); Activities of Daily Living (ADL); Instrumental
Activities of Daily (IADL); Mini Mental State Evaluation
(MMSE); Geriatric Depression Scale (GDS); Mini Nutritional
Assessment (MAN) and Edmonton Symptom Assessment
Scale. The CGA occurred every four months in the first year
and after 2 years of diagnosis
Results:
20 elderly women with average age of 70.2 (±7.03),
received a total of 97 GA in the course of two years. CGA
identified new weaknesses in 90% of cases, with expansion of
the clinical conduct, and 45% of patients had cancer treatment
modified after the evaluation. As monitoring instrument,
there was a downward trend in the number of new diagnoses
after each AGA conducted over two years
Conclusion:
This study validates the importance of using
the AGA in the elderly population with breast cancer in
Brazil to identify weaknesses and suggest changes in cancer
treatment plan. New studies in various cancers and longer
follow-up are needed to assess the impact of AGA in the
elderly undergoing cancer treatment.
References:
[1] Puts MT, Santos B, Hardt J, Monette J, Atenafu EG, Girre V et
al. An update on a systematic review of the use of geriatric
assessment for older adults in oncology. Ann Oncol
2014;25(2): 307–315.
[2] Terret C, Zuliam G, Naiem A, Albrand G. Multidisciplinary
approach to geriatric oncology patient. J Clin Oncol. 2007;
25(14):1876-1881.
Disclosure of interest:
None declared
Keywords:
Breast cancer, geriatric assessment, elderly
patients
P138
ASSESSMENT OF OLDER PATIENTS WITH CANCER:
EDMONTON FRAIL SCALE (EFS) AS A PREDICTOR OF
ADVERSE OUTCOMES IN OLDER PATIENTS UNDERGOING
RADIOTHERAPY
T. Ryan
1
, L. Keenan
1,
*, M. O’Brien
2
, O. McCardle
1
1
Radiation Oncology, SLRON,
2
Geriatrics, Beaumont Hospital,
Dublin, Ireland
Introduction:
In recent years, geriatric oncologists have
been investigating the usefulness of a comprehensive geriatric
assessment (CGA) tool to assess an elderly patient’s suitability
for treatment. The CGA is an extensive multi-disciplinary
assessment tool, taking an hour per patient to complete,
impractical in a busy oncological setting. Shorter assessment
tools have been proposed to assess older patients’ suitability
for treatment, such as the Edmonton-Frail-Score (EFS). The
EFS is a brief, valid, reliable, bedside screening test that can
be completed by a lay researcher and aims to measure frailty.
It includes all the main areas of a CGA (cognitive status,
social well being, physical fitness, co-morbidities, level of
independence, nutritional status.)
Objectives:
A prospective single arm observational study
which examining the EFS as a predictor of adverse events in
older patients undergoing RT in Ireland. It aims to determine
the incidence of adverse events in older patients undergoing
RT (treatment toxicity, unplanned admissions, break in RT
treatment.)