MP04-10 A PROSPECTIVE COHORT STUDY OF 112 ELDERLY PATIENTS WITH BLADDER CANCER: PREDICTIVE FACTORS OF EARLY DEATH AFTER A COMPREHENSIVE GERIATRIC ASSESSMENT

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I1 Apr 2017MP04-10 A PROSPECTIVE COHORT STUDY OF 112 ELDERLY PATIENTS WITH BLADDER CANCER: PREDICTIVE FACTORS OF EARLY DEATH AFTER A COMPREHENSIVE GERIATRIC ASSESSMENT Cyrielle RAMBAUD, Marine SANCHEZ, Sébastien GONFRIER, Matthieu DURAND, Delphine BORCHIELLINI, Hervé QUINTENS, Romain PRADER, Rabia BOULAHSSASS, and Olivier GUERIN Cyrielle RAMBAUDCyrielle RAMBAUD More articles by this author , Marine SANCHEZMarine SANCHEZ More articles by this author , Sébastien GONFRIERSébastien GONFRIER More articles by this author , Matthieu DURANDMatthieu DURAND More articles by this author , Delphine BORCHIELLINIDelphine BORCHIELLINI More articles by this author , Hervé QUINTENSHervé QUINTENS More articles by this author , Romain PRADERRomain PRADER More articles by this author , Rabia BOULAHSSASSRabia BOULAHSSASS More articles by this author , and Olivier GUERINOlivier GUERIN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.148AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Bladder Cancer (Bca) is significantly associated with aging. However, the correct management of BCa in the elderly remains controversial. The aim of the study is to analyse predictive factors of early death in a group of patients >70y, with Bca, at 100 days after a geriatric comprehensive assessment (CGA), in order to help in therapeutic decision making. METHODS 112 patients with Bca were enrolled. This is a multicentric and prospective cohort study approved by an ethics committee. A standardized comprehensive geriatric assessment (CGA) was done before the treatment decision and different geriatric data were collected: MMSE, MNA, BMI, Grip hand grip strength, ADL, IADL, GIRSg, Gait speed, QLQC30, Charlson, G8 and Balducci classification. Characteristics of cancer, social and demographic data were also collected. During a 100-days follow up, the rate of death, treatments made and geriatric interventions were collected. RESULTS A total of 112 patients were enrolled, including 25,9 % of women and a mean age of 82y [70-96]. 26,8% (n=30) of patients died within the 100-days follow up. 34,8%(n=39) of patients had metastatic cancers. The most common proposed treatments, by the surgeron or the oncologist, were surgery (radical cystectomy) (44,6%) and chemotherapy (41,6%). In 35,7% of cases, CGA has modified the therapeutic decision, in favor to palliative care in 57,5%.In univariate analyzes, metastatic cancers (HR= 2,7 [ 1,3-5,5],p=0,008), cognitive deficit (MMSE<24) (HR=3;2[1,5-7],p=0,003), confusion (HR=2,2 [1,1-4,5],p=0,032), under nutrition (MNA<17) (HR=6,9 [2,1-22],p<0,001), lower gait speed (HR=5,6 [2,4-12,9],p<0,001), social isolation (HR=4,5 [2,1-9,6], p<0,001), and loss of autonomy in ADL (HR=2,7 [1,1-6,2],p=0,023) and IADL (HR=2,7 [1,1-6,5],p=0,032) had significantly more risk of dying. The predictive factors of early death, in multivariate analyzes, were the metastatic cancers (HR=3,5 [1,6-7,5], p=0,002), the lower gait speed (HR=3,1 [1,2-7,7], p=0,015), social isolation (HR= 2,6 [1,2-5,9], p=0,02)and loss of autonomy in ADL (HR=3,3 [1,2-9,2],p=0,022). CONCLUSIONS This study confirms that some geriatric data could be predictive of worse outcome. These results can help the geriatrician, the surgeon and the oncologist in decision making. But these data also encourage to propose targeted geriatric interventions to improve the patients's prognosis, especially customize their perioperative care. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e32 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Cyrielle RAMBAUD More articles by this author Marine SANCHEZ More articles by this author Sébastien GONFRIER More articles by this author Matthieu DURAND More articles by this author Delphine BORCHIELLINI More articles by this author Hervé QUINTENS More articles by this author Romain PRADER More articles by this author Rabia BOULAHSSASS More articles by this author Olivier GUERIN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...