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A B S T R A C T S
Results:
IL-6 levels were lower in the EG on 1, 3, and 5 days
post-operatively (p<0.05). IL-6 levels in the Enhanced group,
differently from control group, returned to pre operative
level 3 days after surgery. C-reactive protein level was lower
in the Enhanced group on day 1, 3, and 5 (p<0.05). There
was no difference in Cortisol and Prolactin levels between
groups. Prealbumin serum level was higher on day 5 (p<0.05)
compared to standard group. Postoperative outcomes in terms
of return to oral nutrition, normal bowel function and HLOS
were significantly improved in the ERAS group.
Conclusion:
Colorectal laparoscopic surgery within an
ERAS prototcol in elderly patinets affects Surgical Stress
Response, decreasing IL-6 and CRP levels post-operatively and
improving Prealbumin post operative synthesis.
Disclosure of interest:
None declared
Keywords:
Colorectal surgery, elderly patients, ERAS,
immune function, laparoscopy
P018
OCTOGENARIANS WITH INOPERABLE MALIGNANT
PLEURAL MESOTHELIOMA: OUTCOME OF CARBOPLATIN
AND PEMETREXED CHEMOTHERAPY. A SIX YEARS
CONSECUTIVE COHORT
J. B. Sørensen
1,
*, J. N. Jakobsen
1
1
Dept. Oncology, Finsen Centre/National University Hospital
Copenhagen, Copenhagen, Denmark
Introduction:
Chemotherapy with either cisplatin or
carboplatin together with pemetrexed is evaluated for use in
patients younger than 75 years of age. The safety and efficacy
in older patients is very little explored, and results on such
treatments in patients above 80 years is hithertoo unreported.
Objectives:
The purpose of the present study was to
investigate outcome of carboplatin and pemetrexed in
very elderly patients with inoperable malignant pleural
mesothelioma (MPM) patients aged
80 years (octogenarians).
Methods:
Chemotherapy naïve inoperable MPM patients
aged
80 years with no upper age limit in performance status
(PS) 0-2 with normal renal, bone marrow and hepatic function
were included. The patients received Carboplatin AUC 5 and
Pemetrexed 500 mg/m
2
day 1 every 3 weeks for maximum
6 courses without g-csf. Patients in PS 2 received treatment
with 25% dose reduction.
Results:
Out of a total of 510 newly diagnosed MPM patients
referred to the national centre for Mesothelioma Treatment
in Denmark 2010-2015 there were a total of 32 octogenarians.
The patients were primarily male (75%). The median age was
81 years (80-85 years). 69% had been exposed to asbestos, 19%
had PS 0, 53% had PS 1, and 28% had PS 2. The histological
subtypes represented were epithelioid 47%, sarcomatoid 9%,
and biphasic 44%. Median treatment duration was 4 courses
corresponding to 12 weeks (range 1-6 courses). 38 patients
completed 6 courses. There were no febrile leucopenia
episodes, no bleeding incidents, and no toxic deaths.
Complete response was achieved in one patient (3%),
Partial response in 22%, no change in 53%, and progressive
disease in 28%. Median survival was 13.8 months (range 2.0-
37.3+ months).1-year survival rate was 63% and 2- and 3-years
survival rates 9% and 3%, respectively. 38% received 2nd line
chemotherapy and 16% received palliative radiotherapy after
1th line chemotherapy.
Conclusion:
Very elderly patients aged
80 years were
able to receive carboplatin and pemetrexed with acceptable
toxicity. Outcome is similar as that reported with this
regimen in younger patients, both with respect to response
rate and survival. Palliative chemotherapy is a safe and active
treatment option for very elderly MPM patient above 80 years
of age, however with dose reduction in PS 2 or frail cases.
References:
[1] JB Sørensen. Current concepts in chemotherapy for
Malignant Pleural Mesothelioma. Clinical Respiratory
Journal 2:74-79, 2008.
[2] Jakobsen JN, Sørensen JB: Review on clinical trials of
targeted treatments in malignant mesothelioma. Cancer
Chemotherapy and Pharmacology 68 (1):1-15, 2011
[3] Sørensen JB, Urbanska E, Langer SW, Aamdal E: Second-
line oral Vinorelbine following 1st line Platinum and
Pemetrexed in malignant pleural mesothelioma. European
Journal of Clinical Medical Oncology 4 (4): 6-13, 2012
Disclosure of interest:
None declared
Keywords:
Chemotherapy, malignant pleural mesothelioma,
octogenarians, prognosis, very elderly
P020
MULTIDISCIPLINARY DECISION-MAKING IN LUNG CANCER
PATIENTS: AN AGED BASED COMPARISON
K. J. Schulkes
1,
*, M. E. Hamaker
2
, J. J. Lammers
3
,
M. M. van Rens
1
, M. Geerts
1
, L. J. van Elden
1
1
Pulmonology,
2
Geriatric Medicine, Diakonessenhuis Utrecht,
3
Pulmonology, UMC Utrecht, Utrecht, Netherlands
Introduction:
With the imminent ageing of western
societies and the subsequent rise in the number of older lung
cancer patients, optimising decision making for this patient
population is becoming increasingly urgent. A first step is
to become aware of current clinical practice. We analysed
treatment decisions and course of therapy for older and
younger patients with lung cancer in different age categories:
<65 years, 65-75 years and 75 years and older.
Objectives:
We set out to determine how treatment
decisions for older and younger patients with lung cancer
are currently made by the multidisciplinary team (MDT),
the pulmonologist (as part of the MDT) and the patient. A
secondary goal was to analyse the course of treatment.
Methods:
A total of 349 patients with lung cancer (median
age 67.8 years), discussed at the multidisciplinary team
meeting in the Diakonessenhuis Utrecht, the Netherlands,
were reviewed. Multidisciplinary decision-making and subse-
quent clinical course were extracted from medical files.
Results:
We found that 39% (n=30) of eligible patients older
than 75 years of age received chemotherapy compared to
79% (n=73) of the patients aged 65-75 years and 80% (n=99)