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M.S. Umut
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P3.11 - Poster Session/ Palliative and Supportive Care (ID 231)
- Event: WCLC 2015
- Type: Poster
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.11-003 - Contribution of the Comprehensive Geriatric Assessment on Management of the Cancer Theraphy in Elderly Patients (ID 2895)
09:30 - 09:30 | Author(s): M.S. Umut
- Abstract
Background:
Lung cancer is getting more common and important especially in 6th-7th decade. Several recently published studies showed that eveluating the elderly patients with only Eastern Cooperative Oncology Group (ECOG) to manage the treatment is not eough. It is needed to consider this elderly group of patients precisely. In our study we aim to search the the clinical value of the comprehensive geriatric assessment of the elderly patients as a a parameter that can be used to guide the treatment decision.
Methods:
In our study 65 years old and over newly diagnosed 74 lung cancer patients in our hospital from April 2013 to April 2014 were included. In order to evaluate the comprehensive geriatric assessment, we applied the activities of daily living (ADL’s), instrumental activities of daily living ( IADLs), mini-mental test, mini-nutritional test, Yesavage depression scale and Charlson comorbidity index . Receiving treatment and the survival were assessed with 6 other tests and ECOG in single and multi variable analysis.
Results:
Men were 94.6 % of all patients. In this group 6.8% in small cell carsinoma, 90.5% in non-small cell carsinoma, 2.7 % in malignant epithelial tumour were diagnosed. According to ADL’s 86.5 % was independent and 13.5 % was semi-dependent as well as to IADLs 60.8 % was independent, 20.3 % semi-dependent and 18.9 % was dependent. %12.2 of the patients had malnutrition, %56.7 had malnutrition risk. The data provided that 54 % of all patients had severe dementia and 17.6 % has mild dementia. According to Yesavade depression scale 13.5% of patients were developed depression. Charlson comorbidity index provided the data that 2 % of patients had very high risk probability, 5% high risk, 42.5 % moderate, 25% low risk probability. It is found significant the relationship between the receiving treatment and results of ADL’s, IADLs, mini-mental test, Yesavage depression scale, and ECOG as well as ADL’s, IADLs, mini-mental test, Yesavage depression scale, ECOG and mini-nutritional test and the survival in single variable analysis (p<0,05). In order to consider which test will have more prominent role to receive the treatment ,multivariable analysis was performed and only IADLs was found significant as a determining factor for receiving or not receiving treatment (p=0,003). Yesavage depression scale was found more efficient to find out the factors affecting the survival in multivariable comparison analysis (p=0,011).
Conclusion:
The study published by Maione and collegues evaluating the relationship between functional status, comorbidity, life quality and the survival in 566 advanced stage non-small cell cancer patients showed that patients with beter IADLs ( p= 0.04) have better survival as similarly obtained from our study. Buccheri and his group reported the data from 133 heterogeneous bronchogenic cancer patients developed depression,have a worse survival comparing with the patients having no depression. The results of our study indicates that assessing with ECOG is not enough for considering the treatment,but how CGA is important to consider it as well. Improving the life quality and the survival of the advanced stage elderly patients with cancer, future research requires a more wide population
