Change in the comprehensive geriatric assessment scores at day 30 post-cancer treatment in geriatric oncology patients.

Authors

Toufic Tannous

Toufic Tannous

Roger Williams Medical Center/Boston University School of Medicine, Providence, RI

Toufic Tannous , Dany Debs , Erkan Ceyhan , Ponnandai Sadasivan Somasundar

Organizations

Roger Williams Medical Center/Boston University School of Medicine, Providence, RI, Roger Williams Medical Center, Providence, RI, Rogwe Williams Medical Center, Providence, RI

Research Funding

No funding received
None

Background: The comprehensive geriatric assessment (CGA) is a multidimensional tool for assessing the functional, cognitive, nutritional and frailty status of patients above 65 years of age with cancer. It includes several components: patient health questionnaire (PHQ-9), timed up and go (TUG), mini mental status exam (MMSE), mini nutritional assessment (MNA), Poly Pharmacy (PP), activities of daily living (ADL), instrumental activities of daily living (IADL) and comorbidities. Previous studies showed that some baseline CGA scores (pre-treatment) are predictors of mortality. However, to our knowledge, there has been no study evaluating the change of those scores in response to treatment at different time periods. We sought to evaluate the evolution of the CGA scores after 30 days post-treatment. Methods: We conducted a single institution, prospective cohort registry of patients with solid cancers aged 65 or older in Rhode Island from 2013-2018. All patients underwent a CGA before starting treatment (day 0) and post-treatment (day 30). Treatment included surgery, chemotherapy, radiation, or any combination. Baseline demographic characteristics as well as CGA components were abstracted. TUG, MMSE, PHQ-9, IADL, PP, BMI, MNA and ADL performed at day 0 and 30 were collected. The mean for each score was obtained at both days. Student T test was used to test for significance for nominal data and Chi square test for ordinal data. A P value of less than 0.05 was deemed statistically significant. Results: 283 patients were enrolled. The mean age was 76 (+-6.86) of which 54% were females. 92% of patients were white and 8% were black. Colorectal and lung cancer were among the most common. The mean Charleston comorbidity index was 12.3 (+-3.2). The mean BMI decreased from 26.92 (+-5.84) at day 0 to 26.1 (+-5.45) at day 30 (p < 0.01). The mean IADL decreased from 5.93 (+-2.03) to 5.2 (+-2.12) (p < 0.01). At day 0, one patient had impaired ADLs compared to 7 patients at day 30 (p = 0.03). PHQ-9, MMSE, MNA, TUG and PP scores did not significantly differ at day 30 post treatment (Table). Conclusions: The ADL, IADL and BMI scores showed a statistically significant change at Day 30, indicating deteriorating scores in those patients. Our study showed that ADL, IADL and BMI were the only variables that worsened at day 30 post-treatment compared to PHQ-9, MMSE, MNA, TUG and PP. This suggests that they may be used as early markers of clinical deterioration in geri-onc patients undergoing treatment. More studies are needed to assess their prognostic significance.

CGA variables
Day 0
Day 30
P
BM
26.92 (+-5.84)
26.1(+-5.45)
<0.01
IADL
5.93(+-2.03)
5.2(+-2.12)
<0.01
PHQ-9
5.02(+-4.3)
5.13(+-3.82)
0.72
MMSE
27.01(+-3.38)
26.91(+-3.11)
0.63
MNA
4.96(+-3.44)
5.23(+-2.81)
0.5
TUG
10.23(+-2.52)
10.11(+-1.78)
0.74
PP
51
62
0.12
ADL
1
7
0.03

Mean score and SD sum of all the patients who had PP ⴕ sum of all the patients with impaired ADL.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Geriatric Models of Care

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 12048)

DOI

10.1200/JCO.2021.39.15_suppl.12048

Abstract #

12048

Poster Bd #

Online Only

Abstract Disclosures

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