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Cancer in older patients: New registrations of prostate, breast, colorectal and lung cancer in patients aged 65 and over in England, 1971–2009
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J O U RN A L OF GE R IAT RI C O N COL O G Y 3 ( 2 0 12 ) S3 3 –S 10 2
P38 Cancer in five Italian nursing homes G.L. Cutolo1, G. Santacroce1, R. Sandri1, N. Viti2, F. Pirri2, T. Ricciardi2, A. Cantatore2, P. Cossovich2, D. De Domenico2, I. Rebecchi2, G. Galetti2, S. Monfardini⁎1. 1UO Medicina Oncologica Geriatrica, Italy, 2 RSA, Istituto Palazzolo, Fondazione Don Carlo Gnocchi, Milano, Italy Purpose of the study: No information is presently available on cancer incidence and management in the nursing homes in Italy as well as in the other European countries. The aim of this analysis was to provide information on the characteristic of neoplasia and therapeutic approach in 5 nursing homes Methods: The charts of all neoplastic patients admitted in five nursing homes of the Don Carlo Gnocchi Foundation in the Lombardy Region (Palazzolo, Malnate, Girola, Salice, Pessano) from January 2009 to December 2011 were analyzed for tumor type, age, previous antineoplastic treatment, and associated diseases (CIRS) Results: In these Foundation's nursing homes (total 1074 beds), in the Lombardy region, we observed 136 histologically proven cancer cases. The median age was 86.9 years (range 76–101), 23 (17%) were males and 113 (83%) females. Of 136 evaluable cases 104 were frail (77.6%), 11 vulnerable (8.2%) and 19 fit (14.2%). Breast cancer was observed in 31 pts, of whom 5 with metastatic disease and 4 with locally advanced disease. Hormone therapy was administered in all, but none of these cases was treated with chemotherapy. In 24 cases, a colo-rectal cancer had been diagnosed but only 1 had metastatic disease. Prostatic cancer was observed in 19 cases, 6 of whom handled with hormone therapy. Eleven cases of lung cancer were observed, 2 of whom metatastatic. A genito-urinary cancer was observed in 16 cases: 6 with bladder cancer; 2 ureteral cancer, 2 cervical cancer, 3 endometrial, 1 vulvar, 1 ovarian and 1 kidney. Seven skin tumors were noticed: 4 were melanoma and the other squamous skin cancer. We also noticed 4 cases of lymphoma and 3 cases of chronic leukemia, but only one could receive chemotherapy while being in the nursing home. The remaining 23 cases were distributed among gastroesophageal, pancreatic and head and neck cancer. As a whole, 19 cases were in an advanced stage, but for none, with the exception of a case of malignant lymphoma, chemotherapy was considered while being in the nursing home. Concerning the medical approach to the neoplasia in these patients our impression is that chemotherapy was not considered to be feasible because of frailty, while the endocrine therapy with aromatase inhibitors was administered in all cases with locally advanced and metastatic breast cancer and used in cases with prostatic carcinoma, both for the relative easiness in prescription and administration. Conclusion: The majority of elderly pts in these nursing homes were frail, with a female predominance, cancer being quite often only one of the multiple heavy problems. In these pts, a complete diagnostic assessment may not be possible in all instances .Chemotherapy should be planned all the time in cases with chemosensitive neoplasia such as malignant lymphomas, while in the majority of the other cases should not be excluded a priori. Our preliminary experience in treating with chemotherapy in our division of Geriatric Oncology patients coming from the nursing home within the same institution and replacing them again there after chemotherapy is positive. doi:10.1016/j.jgo.2012.10.039
P39 Melanoma in older patients: An analysis of national and local data T. Collins⁎1, E. Topham2, A. Ring1. 1Brighton and Sussex Medical School, Brighton, UK, 2Dermatology, Brighton General Hospital, Brighton, UK
Purpose of the study: In 2010, 12,800 cases of melanoma were diagnosed in the UK, where melanoma incidence rates have more than quadrupled over the last thirty years.1 Older age is associated with a worse prognosis.2 In this analysis we use national registry data to examine the trends in case registrations of melanoma in older adults over the last 38 years, and to define the current burden of the disease in this population. We also use local data to describe the stage at presentation of older patients with melanoma and their burden of co-morbidities, as these factors will define treatment needs and research priorities. Methods: Data were requested from the Office for National Statistics describing new registrations in England of melanoma (coded as 172 in the 8th and 9th Revisions [ICD-8 and 9] of the International Classification of Diseases and as C43 in the 10th Revision [ICD-10]). Data were available for 1971–2009 and were analysed according to 5 year age bands: which are presented separately for each sex. Data for all registrations of primary cutaneous melanoma (stage 0–III) for all ages were obtained from the Brighton and Sussex University Hospital pathology databases for the period 2001–2006. Data was extracted regarding tumour stage, and a Charlson Co-morbidity Index was calculated for those patients aged ≥60 with melanoma stage IIB–III, where the issue of adjuvant therapies is particularly relevant. Results: From the national data, the number of registrations of melanoma in England in patients aged ≥65 (men and women combined) increased from 276 in 1971 to 4289 in 2009. Forty-four percent of diagnoses in 2009 were made in patients aged 65 and over. In our local data 454 patients were identified with a new diagnosis of primary cutaneous melanoma stage 0–III. Of these patients 220 (48%) were aged 60 or over, and 152 (33%) were aged 70 or over. Older patients were more likely to present with more advanced (stage IIB–III) disease: 22% vs 8.5 % (age≥60 years vs b60, pb 0.01). Thirty-four patients were aged 60 or over and had stage IIB–III disease, of these 18 (53%) had a Charlson score of 0. Conclusions: There has been a large increase in the number of registrations of melanoma in older patients over the last few decades. Older patients are more likely to present with advanced disease, but many remain fit and should be considered for entry into adjuvant therapy trials where they are currently under-represented. References [1] Cancer Statistics for the UK. Available at: http:// info.cancerresearchuk.org/cancerstats/keyfacts/skin-cancer/. Verified 27th July 2012. [2] Balch CM et al. J Clin Oncol 2001 Aug 15;19(16):3622-34. doi:10.1016/j.jgo.2012.10.040
P40 Cancer in older patients: New registrations of prostate, breast, colorectal and lung cancer in patients aged 65 and over in England, 1971–2009 R. Sinha⁎1,2, C. Coyle1, J. Stokoe1,2, A. Ring1,2. 1Clinical Investigation and Research Unit, Royal Sussex County Hospital, Brighton, BN2 5BE, UK, 2Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, UK Purpose of the study: The population in developed countries is ageing. Cancer is a disease of ageing, and this will lead to an increase in the number of older patients diagnosed with cancer. The magnitude of the increase will have significant implications for service provision, resource allocation and research planning because to date older patients have been under-represented in clinical trials. This analysis describes the trends in the number of new cancer registrations in older patients over the last 38 years. Methods/summarised description of the project: Data were requested from the Office for National Statistics describing new registrations of breast, prostate, colorectal and lung cancer in England for patients aged
J O U RN A L OF GE R IAT RI C O N COL O G Y 3 ( 2 0 12 ) S3 3 –S 10 2
65 or over, from 1971 to 2009. Prostate cancer was coded as 185 in the 8th and 9th Revisions (ICD-8 and 9) of the International Classification of Diseases and as C61 in the 10th Revision (ICD-10). Breast cancer was coded as 174 (ICD-8 and 9) and C50 (ICD-10), colorectal cancer as 153 and 154 (ICD-8 and 9) and C18–C21 (ICD 10), and lung cancer as 162 (ICD-8 and 9) and C33–C34 (ICD 10). Data was analysed according to 5 year age bands: 65–69, 70–74, 75–79, 80–84 and 85 and over, and these are presented separately for each sex and tumour. Crude age- and European standardised incidence rates were also calculated. Results: For all 4 cancers with the exception of lung cancer in men, there were increases in both the incidence rates and number of cancer registrations. Number of registrations of prostate cancer increased by 433%, breast cancer 143%, colorectal cancer 137% (males) and 61% (females) and lung cancer 278% (females). The increase in both incidence rates and number of cancer registrations were especially seen in the 80 and over group in breast, colorectal and lung cancer. Conclusions: The increase in number of diagnoses from 1971 to 2009 for these four cancers represents an additional 52,000 cancers per year in patients aged 65 and over. This is likely to increase further with the ageing of the population. doi:10.1016/j.jgo.2012.10.041
P41 Unplanned hospital admissions in senior cancer patients receiving chemotherapy: Preliminary evaluation of the use of prechemotherapy assessment tools in daily care P. Notten⁎1, S. Boudewijns1, H. van Wijck1, Y. Schoon2, J. Lagro2, A. 1 Persoon2, J. Timmer-Bonte1. Dept of Medical Oncology, The Netherlands, 2Dept of Geriatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Purpose of the study: The decision to start systemic therapy in cancer patients, especially in senior cancer patients, is a delicate one, in which possible benefits and risks should be carefully weighed. Treatment related side-effects and unplanned hospital admissions (UHA) have a major impact on the quality of life. Comprehensive geriatric assessment can contribute in the decision making process and the risk evaluation of a specific patient. In 2011, at the department of Medical Oncology of our University Hospital, we implemented the use of a modified version (adapted for oncology patients) of EASYcare [Dutch EASYcare Study] and the toxicity risk stratification schema as developed by Hurria et al [ASCO 2010]. The purpose of this study was to evaluate the information provided by these tools in relation to the incidence of UHA. Methods/summarized description of the project: In the period of May 2011 to July 2012, all consecutive patients aged 70 years or older intending to start chemotherapy were included. Next to standard care, they were subjected to the EASYcare questionnaire by a nurse specialized in geriatric care and the ‘Hurria-risk-stratification schema’. Outcome of both tools was not used to select or make cancer treatment decisions, but to collect structural information of current or foreseen problems in the domains of: personal and medical information, communication, selfcare, mobility, safety, finances, staying healthy, mental health and wellbeing, home caretakers, healthcare use and unmet needs. Patients were prospectively followed during chemotherapy treatment. Main outcome was defined as incidence of UHA. Data from both tools were compared (by descriptive analysis) in admitted patients to patients without UHA. Results: Currently, we completed the analysis in 37 patients (mean age 72 years) treated with both curative as palliative intent (51% and 49% respectively). UHA occurred in 13 (35%) patients, in the majority of patients with curative intent (8/13 pts 62%). Comparison of the main characteristics like age, body mass index, tumorload and most EASYcare results showed no major differences between the two
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groups. However, 3/24 (13%) non-admitted compared to 5/13 (39%) admitted patients were involved in exercise regularly (EASYcare Staying Healthy category). In 3 patients the EASYcare questionnaire prompted for an immediate intervention (in home care services), yet in all 3 UHA occurred. A good Karnofsky Performance score (90–100) was observed more frequently in non-admitted patients (12/24 (50%) compared to 4/13 (30%)). Admitted patients had higher ‘Hurria-risk’ scores (high risk 7/13 (54%) compared to 8/24 (33%)). Conclusions: UHA occurred in approximately 1/3 of our patients. Treatment with curative intent is more frequently associated with UHA. Use of the EASYcare questionnaire in senior cancer patients could, in this preliminary analysis, not identify patients at risk for UHA, except for a reduced level of physical activity before starting chemotherapy. Remarkably, in all 3 patients in whom the EASYcarequestionnaire prompted for an immediate intervention, UHA occurred. Not surprisingly, higher ‘Hurria-risk’ scores seem related to UHA. Further data need to be collected to draw firm conclusions. References [1] Hassett MJ, O'Malley AJ, Pakes JR, Newhouse JP, Earle CC (2006) Frequency and cost of chemotherapy-related serious adverse effects in a population sample of women with breast cancer. J Natol Cancer Inst 98(16):1108–1117. [2] Hassett MJ, Rao SR, Brozovic S et al (2011) Chemotherapy related hospitalization among community cancer center patients. Oncologist 16:378–387. [3] Heather McKenzie & Lillian Hayes & Kathryn White &Keith Cox & Judith Fethney & Maureen Boughton &Jo Dunn. Chemotherapy outpatients’ unplanned presentations to hospital: a retrospective study. [4] Philp I, Newton P, McKee KJ, Dixon S, Rowse G, Bath PA (2001) Geriatric assessment in primary care: formulating best practice. [5] A Randomized Study of a Multidisciplinary Program to Intervene on Geriatric Syndromes in Vulnerable Older People Who Live at Home (Dutch EASYcare Study) Rene´ J. F. Melis, Monique I. J. van Eijken, Steven Teerenstra, Theo van Achterberg, Stuart G. Parker, George F. Borm, Eloy H. van de Lisdonk, Michel Wensing, and Marcel G. M. Olde Rikkert [Clinicaltrials.gov Identifier NCT00105378] The Journal of Gerontology: Medical Sciences 2008;63:283-90. doi:10.1016/j.jgo.2012.10.042
P42 Thrombo-embolic events in geriatric oncology patients; a rural cancer centre perspective S.R. Vemula⁎1, M. George2, S. Sukumaran3. 1New England and Northwest Cancer Care Centre, Tamworth, Australia, 2New England and Northwest Cancer Care Centre, Tamworth, Australia, 3Dept of Medical Oncology, Flinders Medical Centre, Adelaide, Australia Background: Thrombo-embolic events (TEE) are a major cause of morbidity in cancer patients. This study aims to assess the incidence of TEE in geriatric population (N70 years) with cancer from a rural hospital in Australia and to compare the clinical profile with the younger cohort of patients (b70 years). Methods: Retrospective analysis of cancer patients who develop TEE over a period of 4 years (2008 to 2011). Results: Forty patients with a median age of 74 (47–94) years were analysed. Out of these 25 patients were above 70 years of age. Among this group of patients the most common underlying cancer diagnosis was breast cancer (32%) followed by rectum (16%) and prostate (12%) while for patients less than 70 years it was pancreatic cancer (18%), prostate cancer (12.5%) and ovarian cancer (12.5%). 92% of the geriatric group had an ECOG performance status of 0 or 1. 56% of these patients developed TEE as an outpatient, 32% were immobilised,
J O U RN A L OF GE R IAT RI C O N COL O G Y 3 ( 2 0 12 ) S3 3 –S 10 2
P38 Cancer in five Italian nursing homes G.L. Cutolo1, G. Santacroce1, R. Sandri1, N. Viti2, F. Pirri2, T. Ricciardi2, A. Cantatore2, P. Cossovich2, D. De Domenico2, I. Rebecchi2, G. Galetti2, S. Monfardini⁎1. 1UO Medicina Oncologica Geriatrica, Italy, 2 RSA, Istituto Palazzolo, Fondazione Don Carlo Gnocchi, Milano, Italy Purpose of the study: No information is presently available on cancer incidence and management in the nursing homes in Italy as well as in the other European countries. The aim of this analysis was to provide information on the characteristic of neoplasia and therapeutic approach in 5 nursing homes Methods: The charts of all neoplastic patients admitted in five nursing homes of the Don Carlo Gnocchi Foundation in the Lombardy Region (Palazzolo, Malnate, Girola, Salice, Pessano) from January 2009 to December 2011 were analyzed for tumor type, age, previous antineoplastic treatment, and associated diseases (CIRS) Results: In these Foundation's nursing homes (total 1074 beds), in the Lombardy region, we observed 136 histologically proven cancer cases. The median age was 86.9 years (range 76–101), 23 (17%) were males and 113 (83%) females. Of 136 evaluable cases 104 were frail (77.6%), 11 vulnerable (8.2%) and 19 fit (14.2%). Breast cancer was observed in 31 pts, of whom 5 with metastatic disease and 4 with locally advanced disease. Hormone therapy was administered in all, but none of these cases was treated with chemotherapy. In 24 cases, a colo-rectal cancer had been diagnosed but only 1 had metastatic disease. Prostatic cancer was observed in 19 cases, 6 of whom handled with hormone therapy. Eleven cases of lung cancer were observed, 2 of whom metatastatic. A genito-urinary cancer was observed in 16 cases: 6 with bladder cancer; 2 ureteral cancer, 2 cervical cancer, 3 endometrial, 1 vulvar, 1 ovarian and 1 kidney. Seven skin tumors were noticed: 4 were melanoma and the other squamous skin cancer. We also noticed 4 cases of lymphoma and 3 cases of chronic leukemia, but only one could receive chemotherapy while being in the nursing home. The remaining 23 cases were distributed among gastroesophageal, pancreatic and head and neck cancer. As a whole, 19 cases were in an advanced stage, but for none, with the exception of a case of malignant lymphoma, chemotherapy was considered while being in the nursing home. Concerning the medical approach to the neoplasia in these patients our impression is that chemotherapy was not considered to be feasible because of frailty, while the endocrine therapy with aromatase inhibitors was administered in all cases with locally advanced and metastatic breast cancer and used in cases with prostatic carcinoma, both for the relative easiness in prescription and administration. Conclusion: The majority of elderly pts in these nursing homes were frail, with a female predominance, cancer being quite often only one of the multiple heavy problems. In these pts, a complete diagnostic assessment may not be possible in all instances .Chemotherapy should be planned all the time in cases with chemosensitive neoplasia such as malignant lymphomas, while in the majority of the other cases should not be excluded a priori. Our preliminary experience in treating with chemotherapy in our division of Geriatric Oncology patients coming from the nursing home within the same institution and replacing them again there after chemotherapy is positive. doi:10.1016/j.jgo.2012.10.039
P39 Melanoma in older patients: An analysis of national and local data T. Collins⁎1, E. Topham2, A. Ring1. 1Brighton and Sussex Medical School, Brighton, UK, 2Dermatology, Brighton General Hospital, Brighton, UK
Purpose of the study: In 2010, 12,800 cases of melanoma were diagnosed in the UK, where melanoma incidence rates have more than quadrupled over the last thirty years.1 Older age is associated with a worse prognosis.2 In this analysis we use national registry data to examine the trends in case registrations of melanoma in older adults over the last 38 years, and to define the current burden of the disease in this population. We also use local data to describe the stage at presentation of older patients with melanoma and their burden of co-morbidities, as these factors will define treatment needs and research priorities. Methods: Data were requested from the Office for National Statistics describing new registrations in England of melanoma (coded as 172 in the 8th and 9th Revisions [ICD-8 and 9] of the International Classification of Diseases and as C43 in the 10th Revision [ICD-10]). Data were available for 1971–2009 and were analysed according to 5 year age bands: which are presented separately for each sex. Data for all registrations of primary cutaneous melanoma (stage 0–III) for all ages were obtained from the Brighton and Sussex University Hospital pathology databases for the period 2001–2006. Data was extracted regarding tumour stage, and a Charlson Co-morbidity Index was calculated for those patients aged ≥60 with melanoma stage IIB–III, where the issue of adjuvant therapies is particularly relevant. Results: From the national data, the number of registrations of melanoma in England in patients aged ≥65 (men and women combined) increased from 276 in 1971 to 4289 in 2009. Forty-four percent of diagnoses in 2009 were made in patients aged 65 and over. In our local data 454 patients were identified with a new diagnosis of primary cutaneous melanoma stage 0–III. Of these patients 220 (48%) were aged 60 or over, and 152 (33%) were aged 70 or over. Older patients were more likely to present with more advanced (stage IIB–III) disease: 22% vs 8.5 % (age≥60 years vs b60, pb 0.01). Thirty-four patients were aged 60 or over and had stage IIB–III disease, of these 18 (53%) had a Charlson score of 0. Conclusions: There has been a large increase in the number of registrations of melanoma in older patients over the last few decades. Older patients are more likely to present with advanced disease, but many remain fit and should be considered for entry into adjuvant therapy trials where they are currently under-represented. References [1] Cancer Statistics for the UK. Available at: http:// info.cancerresearchuk.org/cancerstats/keyfacts/skin-cancer/. Verified 27th July 2012. [2] Balch CM et al. J Clin Oncol 2001 Aug 15;19(16):3622-34. doi:10.1016/j.jgo.2012.10.040
P40 Cancer in older patients: New registrations of prostate, breast, colorectal and lung cancer in patients aged 65 and over in England, 1971–2009 R. Sinha⁎1,2, C. Coyle1, J. Stokoe1,2, A. Ring1,2. 1Clinical Investigation and Research Unit, Royal Sussex County Hospital, Brighton, BN2 5BE, UK, 2Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, UK Purpose of the study: The population in developed countries is ageing. Cancer is a disease of ageing, and this will lead to an increase in the number of older patients diagnosed with cancer. The magnitude of the increase will have significant implications for service provision, resource allocation and research planning because to date older patients have been under-represented in clinical trials. This analysis describes the trends in the number of new cancer registrations in older patients over the last 38 years. Methods/summarised description of the project: Data were requested from the Office for National Statistics describing new registrations of breast, prostate, colorectal and lung cancer in England for patients aged
J O U RN A L OF GE R IAT RI C O N COL O G Y 3 ( 2 0 12 ) S3 3 –S 10 2
65 or over, from 1971 to 2009. Prostate cancer was coded as 185 in the 8th and 9th Revisions (ICD-8 and 9) of the International Classification of Diseases and as C61 in the 10th Revision (ICD-10). Breast cancer was coded as 174 (ICD-8 and 9) and C50 (ICD-10), colorectal cancer as 153 and 154 (ICD-8 and 9) and C18–C21 (ICD 10), and lung cancer as 162 (ICD-8 and 9) and C33–C34 (ICD 10). Data was analysed according to 5 year age bands: 65–69, 70–74, 75–79, 80–84 and 85 and over, and these are presented separately for each sex and tumour. Crude age- and European standardised incidence rates were also calculated. Results: For all 4 cancers with the exception of lung cancer in men, there were increases in both the incidence rates and number of cancer registrations. Number of registrations of prostate cancer increased by 433%, breast cancer 143%, colorectal cancer 137% (males) and 61% (females) and lung cancer 278% (females). The increase in both incidence rates and number of cancer registrations were especially seen in the 80 and over group in breast, colorectal and lung cancer. Conclusions: The increase in number of diagnoses from 1971 to 2009 for these four cancers represents an additional 52,000 cancers per year in patients aged 65 and over. This is likely to increase further with the ageing of the population. doi:10.1016/j.jgo.2012.10.041
P41 Unplanned hospital admissions in senior cancer patients receiving chemotherapy: Preliminary evaluation of the use of prechemotherapy assessment tools in daily care P. Notten⁎1, S. Boudewijns1, H. van Wijck1, Y. Schoon2, J. Lagro2, A. 1 Persoon2, J. Timmer-Bonte1. Dept of Medical Oncology, The Netherlands, 2Dept of Geriatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Purpose of the study: The decision to start systemic therapy in cancer patients, especially in senior cancer patients, is a delicate one, in which possible benefits and risks should be carefully weighed. Treatment related side-effects and unplanned hospital admissions (UHA) have a major impact on the quality of life. Comprehensive geriatric assessment can contribute in the decision making process and the risk evaluation of a specific patient. In 2011, at the department of Medical Oncology of our University Hospital, we implemented the use of a modified version (adapted for oncology patients) of EASYcare [Dutch EASYcare Study] and the toxicity risk stratification schema as developed by Hurria et al [ASCO 2010]. The purpose of this study was to evaluate the information provided by these tools in relation to the incidence of UHA. Methods/summarized description of the project: In the period of May 2011 to July 2012, all consecutive patients aged 70 years or older intending to start chemotherapy were included. Next to standard care, they were subjected to the EASYcare questionnaire by a nurse specialized in geriatric care and the ‘Hurria-risk-stratification schema’. Outcome of both tools was not used to select or make cancer treatment decisions, but to collect structural information of current or foreseen problems in the domains of: personal and medical information, communication, selfcare, mobility, safety, finances, staying healthy, mental health and wellbeing, home caretakers, healthcare use and unmet needs. Patients were prospectively followed during chemotherapy treatment. Main outcome was defined as incidence of UHA. Data from both tools were compared (by descriptive analysis) in admitted patients to patients without UHA. Results: Currently, we completed the analysis in 37 patients (mean age 72 years) treated with both curative as palliative intent (51% and 49% respectively). UHA occurred in 13 (35%) patients, in the majority of patients with curative intent (8/13 pts 62%). Comparison of the main characteristics like age, body mass index, tumorload and most EASYcare results showed no major differences between the two
S55
groups. However, 3/24 (13%) non-admitted compared to 5/13 (39%) admitted patients were involved in exercise regularly (EASYcare Staying Healthy category). In 3 patients the EASYcare questionnaire prompted for an immediate intervention (in home care services), yet in all 3 UHA occurred. A good Karnofsky Performance score (90–100) was observed more frequently in non-admitted patients (12/24 (50%) compared to 4/13 (30%)). Admitted patients had higher ‘Hurria-risk’ scores (high risk 7/13 (54%) compared to 8/24 (33%)). Conclusions: UHA occurred in approximately 1/3 of our patients. Treatment with curative intent is more frequently associated with UHA. Use of the EASYcare questionnaire in senior cancer patients could, in this preliminary analysis, not identify patients at risk for UHA, except for a reduced level of physical activity before starting chemotherapy. Remarkably, in all 3 patients in whom the EASYcarequestionnaire prompted for an immediate intervention, UHA occurred. Not surprisingly, higher ‘Hurria-risk’ scores seem related to UHA. Further data need to be collected to draw firm conclusions. References [1] Hassett MJ, O'Malley AJ, Pakes JR, Newhouse JP, Earle CC (2006) Frequency and cost of chemotherapy-related serious adverse effects in a population sample of women with breast cancer. J Natol Cancer Inst 98(16):1108–1117. [2] Hassett MJ, Rao SR, Brozovic S et al (2011) Chemotherapy related hospitalization among community cancer center patients. Oncologist 16:378–387. [3] Heather McKenzie & Lillian Hayes & Kathryn White &Keith Cox & Judith Fethney & Maureen Boughton &Jo Dunn. Chemotherapy outpatients’ unplanned presentations to hospital: a retrospective study. [4] Philp I, Newton P, McKee KJ, Dixon S, Rowse G, Bath PA (2001) Geriatric assessment in primary care: formulating best practice. [5] A Randomized Study of a Multidisciplinary Program to Intervene on Geriatric Syndromes in Vulnerable Older People Who Live at Home (Dutch EASYcare Study) Rene´ J. F. Melis, Monique I. J. van Eijken, Steven Teerenstra, Theo van Achterberg, Stuart G. Parker, George F. Borm, Eloy H. van de Lisdonk, Michel Wensing, and Marcel G. M. Olde Rikkert [Clinicaltrials.gov Identifier NCT00105378] The Journal of Gerontology: Medical Sciences 2008;63:283-90. doi:10.1016/j.jgo.2012.10.042
P42 Thrombo-embolic events in geriatric oncology patients; a rural cancer centre perspective S.R. Vemula⁎1, M. George2, S. Sukumaran3. 1New England and Northwest Cancer Care Centre, Tamworth, Australia, 2New England and Northwest Cancer Care Centre, Tamworth, Australia, 3Dept of Medical Oncology, Flinders Medical Centre, Adelaide, Australia Background: Thrombo-embolic events (TEE) are a major cause of morbidity in cancer patients. This study aims to assess the incidence of TEE in geriatric population (N70 years) with cancer from a rural hospital in Australia and to compare the clinical profile with the younger cohort of patients (b70 years). Methods: Retrospective analysis of cancer patients who develop TEE over a period of 4 years (2008 to 2011). Results: Forty patients with a median age of 74 (47–94) years were analysed. Out of these 25 patients were above 70 years of age. Among this group of patients the most common underlying cancer diagnosis was breast cancer (32%) followed by rectum (16%) and prostate (12%) while for patients less than 70 years it was pancreatic cancer (18%), prostate cancer (12.5%) and ovarian cancer (12.5%). 92% of the geriatric group had an ECOG performance status of 0 or 1. 56% of these patients developed TEE as an outpatient, 32% were immobilised,