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A B S T R A C T S
study this population in order to offer adapted and proven
treatment protocols and ensure adequate and optimal care.
Objectives:
The objective of this study is to obtain adequate
profiling of the elderly patients with pancreatic cancer to
better assess factors influencing outcomes and decision-
making.
Methods:
This is a retrospective observational study of
all patients aged older than 75 years old with a diagnosis of
unresectable or metastatic pancreatic cancer at the CHUS
between June 2005 and June 2015. Data was retrieved using
the local patient database program Ariane.
Results:
During the study period, 186 patientswere included
according to the entry criteria. Median age at diagnosis was
82 years old with a slight female gender predominance (52%
vs 48%). Location of the primary tumor was in the head of
the pancreas in 46% of cases, and evenly distributed between
the pancreatic body and tail. Diagnosis was made by the
general practitioners or gastroenterologists in 73.4% of
cases. High blood pressure, diabetes mellitus and coronary
atherosclerosis were the most frequently encountered
comorbidities. Other biochemistry parameters at diagnosis
suggested a more fragile population; median albumin level
of 32 g/L, median creatinine value of 155 µmol/L and minor
anemia (median = 11.7 g/dL). Among the 96 patients who were
offered chemotherapy, only 10 accepted this treatment. ECOG
status was unfortunately far from uniformly documented,
although among the patients treated, all had either ECOG 0
or 1 scores. Nine received Gemcitabine as first line whereas
one patient was treated with Folfirinox. Seven completed the
treatment with the standard regimen dosage for each cycle.
Patients received a median of 5 cycles and end of treatment
was dictated by severe asthenia complicating treatment. Only
2 patients, non-responders, received second-line agents (5FU/
LV) that were subsequently stopped, again for non-response.
Conclusion:
Results of this unicentric observational
retrospective study suggest an overall diminished clinical
performance status in elderly patients diagnosed with
unresectable or metastatic pancreatic cancer when compared
to their younger counterparts. Due to our small sample size, it
remains difficult to draw conclusions on ideal patient selection
criterion and palliative treatment for advanced pancreatic
cancer in the elderly. The present study does, however,
underline the dire need for further studies on the matter.
References
:
[1] Société Canadienne du Cancer
[2] Fondation Canadienne du cancer du pancréas
[3] Oncology Journal, 2014 Jan; 28(1):70-4.
[4] Hurria et al. The Oncologist.2015; 20 :37-44.
[5] National Comprehensive Cancer Network.
Disclosure of interest:
None declared
Keywords:
Pancreas, pancreatic adenocarcinoma,
unresectable pancreatic adenocarcinoma
P029
THE IMPACT OF AN OSTOMY ON OLDER COLORECTAL
CANCER PATIENTS: A CROSS-SECTIONAL SURVEY
N. Verweij
1
, M. Hamaker
2,
*, D. Zimmerman
3
, T. van Loon
3
,
F. van den Bos
4
, A. Pronk
5
, I. Borel Rinkes
6
, A. Schiphorst
5
1
Surgery/Geriatrics,
2
Geriatrics, Diakonessenhuis, Utrecht,
3
Surgery, Tweesteden Ziekenhuis, Tilburg,
4
Internal medicine, Haga
ziekenhuis, Den Haag,
5
Surgery, Diakonessenhuis,
6
Surgery, UMC,
Utrecht, Netherlands
Introduction:
Ostomies are being placed in 35% of patients
after colorectal cancer surgery. Both the overall number of
ostomy carriers as well as the proportion of elderly ostomy
carriers is expected to rise even further in future years due to
increasing life expectancy, ageing of the population and active
screening programs for colorectal malignancies.
Objectives:
As decision-making regarding colorectal
surgery is challenging in the older patients, it is important to
have insight in the potential impact due to ostomies.
Methods:
An internet-based surveywas sent to all members
with registered email addresses of the Dutch Ostomy Patient
Association.
Results:
The response rate was 49%, 932 cases were
included of whom 526 were aged <70 years old (‘younger
respondents’), 301 were aged between 70-79 years old (‘the
elderly’) and 105 were aged
80 years old (‘oldest old’). Almost
all respondents (99%) were living independently. Of the oldest
old, 39% lived alone, compared to 14% of the elderly and 12%
of the younger respondents (p=0.007). Half of the ostomates
had received their ostomy between 3 and 10 years prior to the
survey date. Most respondents (91%) had a colostomy.
Help or assistance for emptying or replacing the bag was
required in 9% of the oldest old (versus 6% of the elderly and
2% of the younger respondents, p<0.001). Ostomy-related
limitations ((instrumental) activities of daily living, day
planning, performing hobbies, participating in social activities
and dealing with other people) were similar in the different
age groups. The oldest old respondents had more difficulties
in being away from home overnight due to the ostomy (20% of
the oldest old versus 11% of the elderly and 9% of the younger
respondents, p=0.02).
Uncertainty and dependency due to the ostomy was
experienced equally by all respondents (in 8-10% and 18-22%
respectively). A reduced quality of life was experienced least
in the oldest old group (24% vs 37% of the elderly and 46% of
the younger respondents, p<0.001).
Experienced limitations and impact decreased as time that
had passed since ostomy placement increased. Respondents
who received their ostomies during the past two years,
experienced most limitations compared to those who had it
for 3-10 years or for
11 years.
The oldest old respondents who received their ostomy
within the past two years needed help with emptying or
changing the bags in 14%, this decreased to 10% and 3% of
the respondents who had their ostomy for 3-10 years and
11
years respectively (p=0.28).
Conclusion:
Older ostomates do not experience more
limitations or psychosocial impact due to the ostomy
compared to their younger counterparts. Over the years,