MO1-2 Geriatric assessment and clinical outcomes for elderly colorectal cancer patients

Abstract

Colorectal cancer (CRC) is commonly diagnosed and elderly patients (pts) account for over 70% of all cancers in Japan. The elderly pts have a higher incidence of severe adverse events (SAEs) due to heterogeneity with variety of physical and/or organ functions, therefore, it is difficult to decide treatment strategies of chemotherapy (CT). Recently, low score (≤14) of geriatric 8 (G8), a screening tool for geriatric assessment has been reported to be associated with poor survival and risk of SAEs in elderly cancer pts. This study was conducted to investigate G8 score and clinical outcomes in elderly CRC pts aged ≥ 65 years. We retrospectively reviewed the record of pts who were consulted for treatment and received a G8 questionnaire at the point of consultation from Apr. 2018 to Mar. 2020. A total of 108 pts were evaluable: median age of 75 years (range, 65-92), 55 males (51%), 99 with PS 0/1 (58%, 33%), 56 with stage 4 (52%). The median G8 score was 11 (range, 4-16) and only 10 pts (9.3%) had normal score of >14. Seventy-six pts received palliative or adjuvant CT: 36 (71%) of 51 pts with metastases and 40 (70%) of 57 pts after curative surgery. There was a significant difference in median G8 score between pts with CT and pts without CT (median G8 11.5 vs 10.8, p=0.032). Twenty-three (30%) of 76 pts started CT with dose reduction mostly due to old age (median G8, 11.5). SAEs were observed in 40 pts (53%) (median G8, 11.3) and the median G8 score was lower in 10 pts who discontinued CT due to AE compared to 30 pts without discontinuation (9.0 vs 11.5, p=0.22). Pts who continued CT had a higher IADL than pts who discontinued CT (74% vs 56%) and most of them started CT without dose reduction. The median G8 score was significantly higher in pts with CT compared to pts without CT. Our study indicated that multiple assessment including G8 scoring might be clinically useful to decide treatment strategies of CT in elderly CRC pts.