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Background: Cancer patients (pts) of >=75 years are an
increasing population at risk both for under- and
overtreatment by anticancer interventions. Comprehensive
geriatric assessment (Wildiers H J Clin Oncol 2014) and
associated geriatric and palliative interventions may improve
reversible vulnerability promoting conditions.
Aim: To assess the number of vulnerable patients in in- and
outpatient cancer clinics in one institution
Method: Prospective, one month assessment of all patients >=
75 years by the G8 screening tool (Decoster L AnnOncol 2015),
oncologist’s perception of need for a supportive/palliative
oncology consult. In the medical charts of all eligible pts the
screening tool and a brief letter was provided, up to 3
reminders were applied. In still missing data (12%) oncology
charts were reviewed for weight loss, oncologists’ documented
anorexia, poor function, cognitive impairment or depressive
symptoms, and number of medications, pts self-perception of
health was set as ”unknown”.
Results: Of 1356 pts screened, 173 (13% of population) were
>=75 years old. 157 G8 were completed (response rate:
91%), of them 86 pts (55%) were identified as vulnerable (1
out of 16 overall). For 12/86 (14%) oncologists’ perceived
spontaneously a palliative oncology consult as appropriate. In
5 not vulnerable (G8 >=14) pts, however, relevant
comorbidities (e.g. cardiovascular) were clinically significant
with regards to anticancer treatment decisions. Oncologists
interest is raising with regards to impact of vulnerability and
anticancer decision-making. Analysis of selected G8 items
contributing to vulnerability as well as applied geriatric and
palliative interventions is ongoing.
Conclusion: A relevant number of unselected cancer pts is
vulnerable based on G8 screening. Application of tailored
oncology geriatric and palliative oncology interventions to
achieve short- to midterm improvement may assist to
avoidance of both over- and undertreatment.