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Background A successful implementation of a geriatric evaluation into daily oncology practice will require a collaborative effort of specialists in the field of cancer and ageing. We set out to explore the geriatricians’ opinions on the current care for older cancer patients and to determine potential obstacles in the incorporation of a geriatric evaluation in oncology. Method A web-based survey sent to Dutch geriatricians. Results The response rate was 43% (95 out of 233). Of these, 57% reported that a geriatric evaluation was being used, but mostly on an ad hoc basis only and not routinely. Although many respondents expressed a desire for a more routine evaluation, nearly half of respondents also stated that improving cancer care at their centre was not a priority for them. Perceived obstacles for a routine implementation of a geriatric evaluation were a lack of time or personnel and a lack of interest on the side of cancer specialists. Conclusion The respondents in our survey report that most cancer elderly patients do not routinely received a geriatric evaluation prior to initiation of oncologic treatment, and many geriatricians reported that optimising care for older patients at their centre was not currently a priority. Given the significant burden and complexity of cancer for the elderly, we encourage geriatricians to make their expertise available to other specialists, providing them with the knowledge they need to optimise their care for older cancer patients.

To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel.

Introduction In the past decades, much attention has been given to the risks of undertreatment of cancer in older patients. We set out to determine whether current treatment of colon cancer in older patients still differs from younger patients and to identify risk factors and physician's reasons for deviation from Dutch treatment guidelines. Patients and methods Retrospective cohort study of all consecutive patients newly diagnosed with colon cancer at the Slotervaart Hospital in Amsterdam from January 2002 to December 2007. Data were collected using clinical charts. Results Of 286 patients, 183 were 70 years or older. Ninety-one percent of older patients received curative surgery and 32% received adjuvant chemotherapy in accordance with guidelines compared to 100% and 85% in the younger group (p = 0.002 and p Conclusion At our centre, guideline adherence for surgery in older patients was high, and deviations were well motivated. Age still seems to be the most important factor for withholding chemotherapy, despite evidence suggesting benefit in selected older patients.

Background Older patients with breast cancer are often not treated in accordance with guidelines. With the emergence of endocrine therapy, omission of surgery can be considered in some patients. The aim of this population-based study was to investigate time trends in surgical treatment between 1995 and 2011, and to evaluate the effects of omitting surgery on overall and relative survival in older patients with resectable breast cancer. Methods Patients aged 75 years and older with stage I–III breast cancer diagnosed between 1995 and 2011 were selected from the Netherlands Cancer Registry. Time trends of all treatment modalities were evaluated using linear regression models. Changes in overall survival were calculated by Cox regression. Relative survival was calculated using the Ederer II method. Results Overall, 26 292 patients were included. The proportion of patients receiving surgical treatment decreased significantly, from 90·8 per cent in 1995 to 69·9 per cent in 2011 (P < 0·001). Multivariable analysis showed that overall survival did not change over time (hazard ratio 1·00 (95 per cent confidence interval (c.i.) 0·99 to 1·00) per year); nor did relative survival (relative excess risk 1·00 (0·98 to 1·02) per year). Conclusion Omission of surgery has become more common in older patients with breast cancer during the past 15 years in the Netherlands, but this has not altered overall or relative survival.

Track 1 Solid Tumours in the Elderly Breast cancer in eldery patients O1 Omission of Surgical Treatment and Survival of Elderly Breast Cancer Patients N.A. De Glas, J. Jonker, E. Bastiaannet, A.J.M. de Craen, C.J.H. van de Velde, S. Siesling, G.-J. Liefers, J.E.A. Portielje, M.E. Hamaker. Surgery, Leiden University Medical Center, Leiden, Geriatrics, Rijnland Hospital, Leiderdorp, Gerontology & Geriatrics, Leiden University Medical Center, Leiden, Research, Comprehensive Cancer Centre, Utrecht, Medical Oncology, Haga Hospital, The Hague, Geriatrics, Diaconessenhuis, Utrecht, Netherlands

Zusammenfassung Zweck der Untersuchung war eine Ausbreitung und genauere Wiederholung der in Comm. No. 214 c beschriebenen Versuche.