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Influence of geriatric consultation with Comprehensive Geriatric Assessment (CGA) on therapeutic decision in elderly cancer patients



Influence of geriatric consultation with Comprehensive Geriatric Assessment (CGA) on therapeutic decision in elderly cancer patients



Journal of Clinical Oncology 26(15_Suppl): 9581-9581



NlmCategory="UNASSIGNED">9581 Background: Elderly patients represent an heterogeneous population in which anticancer therapeutic decision is often difficult. CGA has been described as useful for therapeutic decision in elderly cancer patients. We report one year activity of the geriatric assessment consultation of our institution, and its impact on final therapeutic decision. Since January 2007, we propose a geriatric consultation for elderly cancer patients for whom therapeutic decision appears complex to oncologists. This consultation included a CGA, with focuses on items like comorbidity, dependence, cognitive impairment, depression and malnutrition using international well known scales. In 2007, 76 elderly patients (25 men, 51 women) (median age 82 years, extremes 73 -94) were seen at the geriatric consultation. Most of the patients (65/76) were in fist line treatment for colorectal (25), other digestive (19), breast (10) and pulmonary (6) cancers. Cancer was metastatic in 36 patients (47 %). Geriatric assessment found severe comorbidity (grade 3 or 4 in CIRS-G scale) in 24 patients; dependence for at least one activity of daily living (ADL) in 16 patients; cognitive impairment in 19 patients, including 8 patients with already diagnosed Alzheimer disease; malnutrition in 46 patients (60 %); depression in 22 patients. According to prior oncologist decision, there have been no change in therapeutic decision in 16 patients only. Geriatric interventional treatment was delivered to 55 patients (72 %). Anticancer treatment was changed in 36 patients (47 %), including delayed therapy in 4 patients, less intensive therapy in 15 patients and more intensive therapy in 17 patients. Patients for whom final decision was delayed or less intensive therapy had significantly more frequent severe comorbidity (13/19, p < 0.01), dependence for at least one ADL (8/19, p < 0.01) and cognitive impairment (9/19, p < 0.05).Patients for whom final decision was more intensive therapy had significantly more frequent metastatic cancer (14/17, p < 0.01). Geriatric evaluation did influence final therapeutic decision in 79 % of elderly patients in our study. Follow up and updated data will be presented to evaluate quality of final therapeutic decision. No significant financial relationships to disclose.

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Accession: 058112198

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PMID: 27950252


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