64 / 154
S34
A B S T R A C T S
Conclusion:
Data from our cohort shows that there is a
strong association between GPS 2 and frailty. Due to the low
sensitivity, a GPS score alone cannot be used as a screening
tool for frailty, although a GPS 2 indicates frailty with a high
specificity.
Disclosure of interest:
None declared
Keywords:
Frailty, Glasgow prognostic score (GPS)
O18
A CLINICAL SCORE TO PREDICT THE EARLY DEATH AT 100
DAYS AFTER A COMPREHENSIVE GERIATRIC ASSESSMENT
(CGA) IN ELDERLY METASTATIC CANCERS, ANALYSIS FROM
A PROSPECTIVE COHORT STUDY WITH 1048 PATIENTS
R. Boulahssass
1,
*, S. gonfrier
1
, M. Sanchez
1
, V. Mari
2
,
C. Rambaud
1
, J. M. Ferrero
2
, D. Saja
2
, J. M. Turpin
1
, A. Gary
1
,
E. Francois
2
, O. Guerin
2
1
Chu de Nice,UCOG Paca Est,
2
Centre antoine Lacassagne, Nice, France
Introduction:
Trying to predict the very early death after
a CGA is difficult in elderly metastatic cancers. Last year, we
presented a clinical score to predict this risk in 815 elderly
cancer patients (Boulahssass et al 9511 ASCO 2015).
Objectives:
The aim of this new study is the next step by
developing a score to estimate the risk of early death at 100
days in metastatic cancers (MC) in order to have the collective
wisdom not to overtreat this population.100 days is nearly
3 months, if patients are going to die within 3 months, it’s
maybe necessary to provide them best supportive care alone.
Methods:
This is a multicentric and prospective cohort
study approved by an ethics committee. At the baseline, a
standardized CGA was performed (MMSE, MNA, Grip strength,
ADL, IADL, CIRSg, Charlson, lee, PS, Gait speed, QLQc30, G8,
Balducci), type and localization of metastases were collected.
During the follow up of 100 days, events, treatments made
and targeted geriatric interventions were collected. A
multivariate logistic regression permits to select risk factors.
The internal validation was performed by a bootstrap with
randomized samples. Score points were assigned to each risk
factor by using the
coefficient. The accuracy of the score was
assessed with the mean c-statistic and the calibration with
the Hosmer-Lemeshow goodness of fit test.
Results:
In the cohort 312 patients had a MC with a
median age of 82y. The independent predictors of death at
100 days in MC were: Age
85y (OR 2,1 p=0,03), Metastatic
localizations (ML): 2ML (OR 2,4 p=0,004),
2 ML (OR 6,3
p=0,001),MNA <17 (OR 8,7 p<0,0001) or
23,5 and
17 (OR 5,4
p=0,002), Home confinement (OR 1,8 p=0,047), ADL <5,5 (OR
2,1 p=0,017),Cancers with global risk of early death at 100 days
30% (OR 2,05 p=0,016).We assigned in the score: 3 points for:
MNA
23,5, ML
2 and 1 point for home confinement, ADL <5,5,
ML=2, age
85y and types of cancers at risk
30%.The risk of
death at 100 days in MC was 4% for 0 to 2 pts, 18% for 3 to 4
pts,33% for 5 pts and 44% for 6 pts and 83% for
6 pts .
Conclusion:
In daily practice, this score should help to
avoid unnecessary treatment for patients with a high risk of
death, especially for those with a score
6.
Disclosure of interest:
None declared
Keywords:
Elderly cancer patients, geriatric assessment,
metastasis, score
O19
AN OBSERVATIONAL STUDY OF THE INTERVENTIONS
PROVIDED BY A MULTIDISCIPLINARY TEAM PROVIDING
COMPREHENSIVE GERIATRIC ASSESSMENT TO OLDER
ADULTS WITH UPPER GASTRO-INTESTINAL CANCERS
R. Morris
1
, A. Sims
1,
*, A. Smith
1
1
Health Care for Older People, Nottingham University Hospitals
NHS Trust, Nottingham, United Kingdom
Introduction:
Cancer is a disease of older age. U.K Cancer
registration statistics from 2014 show that 50.2% of new
cancers diagnoses were made in those aged 70 and above
[1]. There is a growing body of evidence that Comprehensive
Geriatric Assessment (CGA) can be of value in planning the
care of older people with cancer; it can identify previously
undiagnosed medical conditions, predict the risk of treatment
related toxicity, [2] and help predict surgical outcomes in older
patients with cancer [3].
The SCOPES (Systematic Care of Older People in Elective
Surgery) Oncology team delivers CGA to older adults, aged
70 and older diagnosed with Gastro-oesophageal cancers, in
order to optimise their medical, psychological and functional
status in advance of cancer treatments.
Objectives:
To examine the difference in the number
of interventions provided by the SCOPES Oncology multi-
disciplinary team for patients on a curative treatment
pathway, and those on a palliative treatment pathway.
Methods:
Consecutive patients (
70yrs) referred to the
UGI Cancer Multi-Disciplinary Team (MDT) were invited for
assessment in a multi-professional Geriatric Assessment
Clinic. All patients were assessed by geriatrician, nurse,
occupational therapist, physiotherapist, dietician and social
worker. Planned interventions were delivered and followed-
up by the CGA team. CGA team plans from 178 patients with
gastric and oesophageal cancers from an 18-month period
were reviewed, and the MDT actions recorded and classified.
Results:
99 patients were on a palliative care pathway (64
male, 35 female), 79 (54 male, 25 female) were on a curative
pathway. Ages ranged from 66-90 years for curative patients,
and 62-98 years for palliative patients.
Curative patients received on average 4.81 interventions
with thehighest number of interventions fromthemedical and
nursing staff. Palliative care patients received on average 6.4
interventions with the highest number of interventions being
provided by the social work members of the multidisciplinary
team.
Conclusion:
Comprehensive Geriatric Assessment is of
value in assessing the medical, psychological and functional
needs of both curative and palliative patients. The higher
number of medical and nursing interventions in the
curative group could be explained by the need for additional
investigation and pharmaceutical rationalization required to