possibility to develop new country-specific guidelines and best practices for implementation across Europe and for improved management of older multimorbid patients with cancer.

Limited data exists on end-of-life (EOL) health care utilization in older patients (pts) with cancer. Via data linkage, this study aims to describe EOL care for older pts with cancer and explore the association between geriatric screening and assessment (GS/GA) results at cancer diagnosis and EOL care. Data linkage of GS/GA, cancer registry and administrative health data was performed based on a unique patient identifier. GS/GA data were derived from a large Belgian study (n=22 centers; 2009-2015) where pts aged ≥70 years were screened with G8 followed by GA in case of an abnormal G8 result (≤14/17). For this study pts with a new diagnosis were included when they died before end of follow-up (1/3/2019). Tumor characteristics and vital status were derived from cancer registry data and cause of death from death certificates. Place of death was derived from healthcare reimbursement data. 4,475 pts who died after a median of 13 months were included. The median age was 79 (range: 70–100) and 52.0% were female. Lung, breast and colon cancer were the most common diagnoses and 40.5% had stage IV disease. 81.8% of pts had an abnormal baseline G8. For 81.0% of pts the underlying cause of death was cancer (Table). The majority of pts died in a non-palliative care unit of the hospital (42.3%), followed by at home (25.4%), the palliative care unit of the hospital (16.8%) and nursing home (15.5%). When comparing pts with a normal and abnormal baseline G8 score, there were no major differences in cause and place of death except for a higher percentage with abnormal G8 dying in a nursing home (16.9% vs 9.3%).Table: 1265MOAll ptsPts with normal G8 score (>14/17)Pts with abnormal G8 score (≤14/17)(N=4,475)(N =814)(N =3,661)N (%)N (%)N (%)Underlying cause of deathCancer (ICD-10: C00-D48)3,260 (81.0)575 (83.3)2,685 (80.5)Other*764 (19.0)115 (16.7)649 (19.5)Missing451124327Place of deathHospital: non- palliative care unit1,892 (42.3)361 (44.3)1,531 (41.8)Hospital: palliative care unit753 (16.8)137 (16.8)616 (16.8)Nursing home693 (15.5)76 (9.3)617 (16.9)Home**1,137 (25.4)240 (29.5)897 (24.5)*most common: hearth failure, chronic obstructive pulmonary disease and acute myocardial infarction**place of death was considered home if the patient didn't die in hospital or nursing home Open table in a new tab *most common: hearth failure, chronic obstructive pulmonary disease and acute myocardial infarction **place of death was considered home if the patient didn't die in hospital or nursing home When older pts with a new cancer diagnosis die in the following years, cancer is the underlying cause of death for >80%, both for pts with normal and abnormal baseline G8 score. The majority of pts die in a hospital and only a quarter of pts die at home. This knowledge is important for incorporation of advanced care planning within this patient population.

Using the EORTC Global Health Status (GHS) scale, we aimed to determine minimal clinically important differences (MCID) in health-related quality of life (HRQOL) changes for older cancer patients with a geriatric risk profile, as defined by the geriatric 8 (G8) health screening tool, undergoing treatment. Simultaneously, we assessed baseline patient characteristics prognostic for HRQOL changes.

Background In the general older population, geriatric assessment (GA)-guided treatment plans can improve overall survival, quality of life and functional status (FS). In GA-related research in geriatric oncology, studies mainly focused on geriatric screening and GA but not on geriatric recommendations, interventions and follow-up. The aim of this study was to investigate the adherence to geriatric recommendations and subsequent actions undertaken in older patients with cancer. Patient and methods A prospective Belgian multicenter (N = 22) cohort study included patients ≥70 years with a malignant tumor upon oncologic treatment decision. Patients with an abnormal result on the geriatric screening (G8 ≤14/17) underwent GA. Geriatric recommendations were formulated based on GA results. At follow-up the adherence to geriatric recommendations was documented including a description of actions undertaken. Results From November 2012 till February 2015, G8 screening was carried out in 8451 patients, of which 5838 patients had an abnormal result. Geriatric recommendations data were available for 5631 patients. Geriatric recommendations were made for 4459 patients. Geriatric interventions data were available for 4167 patients. A total of 12 384 geriatric recommendations were made. At least one different geriatric recommendation was implemented in 2874 patients. A dietician, social worker and geriatrician intervened most frequently for problems detected on the nutritional, social and functional domain. A total of 7569 actions were undertaken for a total of 5725 geriatric interventions, most frequently nutritional support and supplements, extended home care and psychological support. Conclusions This large-scale Belgian study focuses on the adherence to geriatric recommendations and subsequent actions undertaken and contributes to the optimal management of older patients with cancer. We identified the domains for which geriatric recommendations are most frequently made and adhered to, and which referrals to other health care workers and facilities are frequently applied in the multidisciplinary approach of older patients with cancer.