Search

e23035 Background: According to the World Health Organization (WHO), the definition of "elderly" varies according to the degree of development of the country. In Low and Medium Development Countries (LMDC), a person aged 60 or older is considered elder, opposed to developed countries (65 or older). It is in LMDC that is occurring the largest relative increase in the incidence of cancer, specially those related to aging. The Comprehensive Geriatric Assessment (CGA) is still underutilized in oncological clinical practice, especially in LMDC. Objectives: To determine predictive factors for the occurrence of early death (in the first six months of surveillance) and to perform the development and temporal validation of a practical prognostic score based on the CGA to predict early death (up to 180 days) in elderly cancer patients. Methods: A prospective cohort enrolled elderly patients ≥ 60 years with a recent cancer diagnosis admitted between 2015-2017. The CGA performed at the time of admission included the following instruments: CCI; KPS; MMSE; TUG test; IPAQ; ADL; MNA; MNA-SF; GDS15; PPS and Polypharmacy. The studied outcome was early death, defined as the one that occurred within the first six months after the diagnosis. Survival analysis (Kaplan-Meier) and Cox proportional hazard regression was performed. Results: 889 patients were included in the study, performed at a referral center in cancer of a teaching hospital in Northeastern Brazil. The independent risk factors for death identified by CGA were: Mini exam of mental state (MMSE) as a continuous variable (HR 1.04 95% CI 1.00-1.07), Geriatric depression scale (GDS-15) ≥ 10 (HR 1 , 50 IC95% 1.10-2.07), Karnofsky Functional Performance Scale (KPS) < 50 (HR 1.57 IC95% 1.02-2.42), Katz Index ≤4 (HR 2.58 IC95% 1.68-3.97) and the Mininutrition assessment (MAN-SF) < 12 (HR 2.96 IC95% 2.00-4.39), with higher risk for early death amongst patients with abnormalities detected by the scales performed at admission (log rank < 0.001). Conclusions: Comprehensive geriatric assessment is an important tool to identify fragility in elderly cancer patients. Some of its scales should be incorporated into clinical practice, as they are simple and significant prognostic markers and identify patients with a higher risk of death in the first twelve months.

e23036 Background: The G8, a questionnaire with 8 questions, has been specifically developed as a screening tool for vulnerability in older patients (70+) with cancer, with results suggesting 14 points as a threshold (equivalent to 90% sensitivity and 60% specificity). Its prognostic value for early death was not evaluated in Brazilian population. Methods: Cancer patients (60 years or older) with solid organ malignancies were included in a prospective cohort in a Brazilian Geriatric Oncology Clinic, between 2015 and 2017. Before the start of any oncologic therapy, a Comprehensive Geriatric Assessment (CGA) with 12 questionnaires was performed. For this study, we analyzed the G8 (Figure 1) considering items from Mini Nutritional Assessment (MNA), polypharmacy ( > 3 medications per day), self reported health status and the age of patient. G8 score was considered abnormal if ≤14, and early death (within six months of surveillance) was the gold standard for the study accuracy. Cox proportional hazard risk and Kaplan-Meier survival curves were performed. Results: 889 patients were enrolled and there were 145 (16.3 %) early deaths. Overall, 52% were male, the extremes of age were from 60 to 97 (mean 72.5 ± 0.24), and 38% were < 70 years old. The most common cancers were prostate (31.2%), digestive tract (21.9%) and breast (16.0%); 30.4% were metastatic. 470 (52,9%) from all patients had abnormal (≤ 14) G8 score; 128 (27.2%) who had abnormal G8 score died within the first 6 months, versus 17 (4.1%) with normal score (Table 1). At cut point 14, the G8 sensitivity was 88.3% (CI95% 81.9 - 93.0); specificity 54.0% (CI95% 50.4 - 57.7); positive predictive value 27.2% (CI95% 23.3 - 31.5); negative predictive value 95.9% (CI95% 93.6 - 97.5); area under ROC curve was 0.819 (Figure 2). For those older than 70, the G8 sensitivity was 91% (CI95% 83.4 - 96.1). Abnormal scores showed significant differences in survival probability (Figure 3). Conclusions: G8 score is a strong and consistent predictor of overall 6-month survival, regardless of age, metastatic status or tumor site in Brazilian older (60 or older) oncologic patients. This finding strengthens the clinical utility of this instrument in the Geriatric Oncology and may be an option to extend the practice of Geriatric Assessment in countries with medium-low economic development, even in the younger elderly population.

10049Background: Recognizing prognostic factors is important when evaluating elderly people with cancer to decide the appropriate treatment. The Oncogeriatric Index (OGI) was developed to predict e...