Management of older cancer patients: updated recommendations of the International Society of Geriatric Oncology (SIOG)

11511 Background: Older cancer patients value functional outcomes as much as survival but surgical studies lack functional recovery (FR) data. The international, multicenter GOSAFE study (ClinicalTrials.gov NCT03299270) aims to evaluate patients’ quality of life (QoL)and FR after cancer surgery and to assess predictors of FR. Methods: GOSAFE prospectively collects functional and clinical data before and after major elective cancer surgery on senior adults (≥70 years). Surgical outcomes are recorded (30 days, 90 days, and 180 dayspost-operatively) with QoL(EQ-5D-3L) and FR (Activities of Daily Living (ADL) + Timed Up and Go (TUG) + MiniCog), 28centers are prospectively enrolling patients; accrual ends February 2019. Results: 643 patients underwent major cancer surgery with curative(94%) or palliative (6%) intent (February 2017-September 2018). Median age was 78(range 70-94); 51.6% males, ASA III-IV 52%. Patients dependent (ADL < 5) were 8%. Frailty was detected by G8 > 14 in 32% and fTRST≥2 in 36% of patients. 639 (99%) lived at home, 32% lived alone, and 88% were able to go out. Major comorbidities (CCI > 6) were detected in 36% and 22% had cognitive impairment according to MiniCog (5% self-reported). 26% had > 3 kg weight loss, 30% were hospitalized in the last 90 days, 45% had ≥3 medications (6% none). For 471 patients, a 90-day comprehensive evaluation was available. Postoperative morbidity was 42% (30 day) and 63.3% (90 day), but Clavien-Dindo III-IV complications were only 11.2% and 17.6%. 90-day mortality was 7.4% (5% 30-day). QoL improved 90 days after surgery (mean EQ-5D index from 0.76 to 0.80). Patients with EQ-5D VAS score > 60 raised from 73.9% at baseline to 82.8% at 90 days. 29% had complete FR (ADL score > 4, MiniCog > 2, TUG < 20). Decreased functional capacity was seen in 23.4% of patients alive at 90-days. Conclusions: GOSAFE is the largest prospective study on older cancer patients undergoing major surgery. Interim analysis reports decreased functional capacity in a quarter of patients. The study will allow clinicians to associate clinical outcomes with individual factors of the preoperative assessment and create a user-friendly tool to predict outcomes that matter to patients.

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1302 POSTER Updated International Society of Geriatric Oncology (SIOG) recommendations for the use of bisphosphonates in elderly cancer patients with bone metastases

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(07)70728-0 ◽

2007 ◽

Vol 5 (4) ◽

pp. 174

Author(s):

J.J. Body ◽

R. Coleman ◽

P. Clezardin ◽

C. Ripamonti ◽

R. Rizzoli ◽

...

Keyword(s):

Bone Metastases ◽

Cancer Patients ◽

International Society ◽

Geriatric Oncology ◽

Elderly Cancer Patients

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Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations

Annals of Oncology ◽

10.1093/annonc/mdm011 ◽

2007 ◽

Vol 18 (8) ◽

pp. 1314-1321 ◽

Cited By ~ 104

Author(s):

V Launay-Vacher ◽

E Chatelut ◽

S.M. Lichtman ◽

H Wildiers ◽

C Steer ◽

...

Keyword(s):

Clinical Practice ◽

Renal Insufficiency ◽

Cancer Patients ◽

International Society ◽

Geriatric Oncology ◽

Elderly Cancer Patients ◽

Practice Recommendations

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International Society of Geriatric Oncology (SIOG) recommendations for the adjustment of dosing in elderly cancer patients with renal insufficiency

European Journal of Cancer ◽

10.1016/j.ejca.2006.11.004 ◽

2007 ◽

Vol 43 (1) ◽

pp. 14-34 ◽

Cited By ~ 174

Author(s):

Stuart M. Lichtman ◽

Hans Wildiers ◽

Vincent Launay-Vacher ◽

Christopher Steer ◽

Etienne Chatelut ◽

...

Keyword(s):

Renal Insufficiency ◽

Cancer Patients ◽

International Society ◽

Geriatric Oncology ◽

Elderly Cancer Patients

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Palliative care needs: Symptom reporting during geriatric oncology evaluation.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.31_suppl.184 ◽

2014 ◽

Vol 32 (31_suppl) ◽

pp. 184-184

Author(s):

Marie Anne Flannery ◽

Chintan Pandya ◽

Mohamedtaki Abdulaziz Tejani ◽

Charles Stewart Kamen ◽

Allison Magnuson ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Cancer Patients ◽

Geriatric Oncology ◽

Older Individuals ◽

Symptom Experience ◽

Care Needs ◽

Older Cancer Patients ◽

Palliative Care Needs

184 Background: Although extensive descriptive work has been conducted on the symptom experience in cancer, relatively little is known about the specific palliative care needs for geriatric oncology populations. When all age groups are studied older individuals report less symptoms and the symptom experience of older cancer patients is minimized. Utilizing data collected from two geriatric oncology referral clinics the primary aim of this study was to identify geriatric oncology patients’ symptom reports, the number of symptoms experienced, and interference reported from symptoms. Methods: Patients referred to a geriatric oncology consult clinic were asked to complete the MD Anderson Symptom Inventory (MDASI) total of 13 items. In addition all patients underwent comprehensive geriatric assessment with a battery of tests. Results: 192 patients completed the symptom inventory with a median age of 81 years (range 65-95). 94% of patients reported at least one symptom, >45% reported experiencing 10 of the 13 symptoms (mean number of symptoms =5.7, SD= 3.7). Most frequently reported symptoms were in order: drowsiness, trouble remembering, dry mouth, disturbed sleep, pain, distress, decreased appetitive, dyspnea, and sadness. Severity ratings for individual symptoms M’s= 0.3-2.5, although the complete range of 0-10 was reported. 67% of patients reported that symptoms were interfering with their quality of life, general activity level and walking ability. Conclusions: In contrast to the myth that older cancer patients have minimal symptoms, at time of referral to a geriatric oncology consultation patients report on average experiencing six symptoms which interfere with their quality of life. There is an intersection between geriatric oncology and palliative care and these descriptive findings highlight the importance of systematic symptom assessment for older individuals with cancer to identify needed symptom relief strategies.

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