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Predictive factors of early death after a comprehensive geriatric assessment in elderly cancer patients.

2015; Lippincott Williams & Wilkins; Volume: 33; Issue: 15_suppl Linguagem: Inglês

10.1200/jco.2015.33.15_suppl.e20530

1527-7755

Beatriz Jiménez-Munárriz, Rosário Madero, A.M. Jiménez Gordo, MJ Molina-Garrido, Juana Saldaña, Regina Gironés, Javier de Castro, Virginia Martínez-Marín, Patricia Cruz, Mar Sánchez, Maite Antonio Rebollo, Beatriz Castelo, Marisa Torres, Andrés Redondo, Beatriz Martínez, Ana Custodio, I. Ghanem Cañete, Elsa Bernal, Jaime Feliú,

Frailty in Older Adults

e20530 Background: Objective data for decision making about treatment options in the elderly population with cancer are lacking. The purpose of this study is to analyze predictive factors of early death ( < 6 months) in older patients after initiation of chemotherapy treatment. Methods: 126 cancer patients ≥ 70 years were enrolled between January of 2012 and December of 2014. This is a prospective cohort study approved by the ethics committee of La Paz University Hospital in Madrid, Spain. A comprehensive geriatric assessment (CGA) was completed before the treatment was started. Geriatric data (Short portable mental status questionnaire – Pfeiffer -, BMI, short physical performance battery –SPPB-, ADL, IADL, HDAS score, Charlson, VES-13 and the MOS social scale) were collected. Cancer characteristics, social, demographic and analytical data were also reviewed. Predictive factors of early death were obtained from a CGA results and traditional oncology measures. Results: Median age was 77 years (70-92), 64% of the patents were male, with advanced disease in 53% of patients. ECOG PS of 0/1/2 was seen in 30%/ 61% and 9% respectively. VES 13 ≥ 7 in 14%. ADL and IADL showed impairment in 17% and 49% of the patients respectively. Thirty seven (29%) of the patients had an early death. In the multivariate analysis, significant predictive factors for early death were: a diagnosis of lung cancer (odds ratio [OR],17.85; 95%CI,[2.86 to 111.40]), metastatic disease (OR 6.9; 95%CI,[1.98 to 24.3]), lower hemoglobin levels (OR 0.553; 95% CI, [0.388 to 0.79]), and higher bilirubin level (OR, 6.403; 95% CI, [1.22 to 33.43]). Interestingly no instrument of geriatric assessment proved capable of predicting survival in our series. ROC analysis showed a good discriminatory capacity (AUC = 0.860). Conclusions: Lung cancer, metastatic disease, hemoglobin and bilirrubin levels were independent predictive factors for early death in elderly cancer patients treated with chemotherapy.