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BACKGROUND: Little evidence is available on the long-term health-care utilisation of older patients with cancer and whether this is associated with geriatric screening results. We aimed to evaluate long-term health-care utilisation among older patients after cancer diagnosis and the association with baseline Geriatric 8 (G8) screening results. METHODS: For this retrospective analysis, we included data from three cohort studies for patients (aged ≥70 years) with a new cancer diagnosis who underwent G8 screening between Oct 19, 2009 and Feb 27, 2015, and who survived more than 3 months after G8 screening. The clinical data were linked to cancer registry and health-care reimbursement data for long-term follow-up. The occurrence of outcomes (inpatient hospital admissions, emergency department visits, use of intensive care, contacts with general practitioner [GP], contacts with a specialist, use of home care, and nursing home admissions) was assessed in the 3 years after G8 screening. We assessed the association between outcomes and baseline G8 score (normal score [>14] or abnormal [≤14]) using adjusted rate ratios (aRRs) calculated from Poisson regression and using cumulative incidence calculated as a time-to-event analysis with the Kaplan-Meier method. FINDINGS: 7556 patients had a new cancer diagnosis, of whom 6391 patients (median age 77 years [IQR 74-82]) met inclusion criteria and were included. 4110 (64·3%) of 6391 patients had an abnormal baseline G8 score (≤14 of 17 points). In the first 3 months after G8 screening, health-care utilisation peaked and then decreased over time, with the exception of GP contacts and home care days, which remained high throughout the 3-year follow-up period. Compared with patients with a normal baseline G8 score, patients with an abnormal baseline G8 score had more hospital admissions (aRR 1·20 [95% CI 1·15-1·25]; p

This study aims to describe end-of-life (EOL) care in older patients with cancer and investigate the association between geriatric assessment (GA) results and specialized palliative care (SPC) use. Older patients with a new cancer diagnosis (2009–2015) originally included in a previous multicentric study were selected if they died before the end of follow-up (2019). At the time of cancer diagnosis, patients underwent geriatric screening with Geriatric 8 (G8) followed by GA in case of a G8 score ≤14/17. These data were linked to the cancer registry and healthcare reimbursement data for follow-up. EOL care was assessed in the last three months before death, and associations were analyzed using logistic regression. A total of 3546 deceased older patients with cancer with a median age of 79 years at diagnosis were included. Breast, colon, and lung cancer were the most common diagnoses. In the last three months of life, 76.3% were hospitalized, 49.1% had an emergency department visit, and 43.5% received SPC. In total, 55.0% died in the hospital (38.5% in a non-palliative care unit and 16.4% in a palliative care unit). In multivariable analyses, functional and cognitive impairment at cancer diagnosis was associated with less SPC. Further research on optimizing EOL healthcare utilization and broadening access to SPC is needed. ispartof: Cancers vol:15 issue:13 pages:3349- ispartof: location:Switzerland status: published

Levi Francis1, Ducreux Michel2, Bouchahda Mohamed3, Smith Denis4, Karaboue Abdoulaye5, Hebbar Mohamed6, Lepere Celine7, Focan Christian8, Guimbaud Rosine9, Innominato Pasquale10, Carvalho Carlos11, Tumolo Salvatore12, Truant Stephanie13, Castaing Denis14, Boige Valerie15, Rougier Philippe16, Morere Jean-Francois17, Adam Rene18 INSERM UMR 776, Medical Oncology Unit, Paul Brousse Hospital, Villejuif, France Institut Gustave Roussy, Paris, France INSERM UMR 776, Medical Oncology Unit, Paul Brousse Hospital, Villejuif, France University Hospital, Bordeaux, Gironde INSERM UMR 776, Paul Brousse Hospital, Villejuif, France Medical Oncology Unit Hopital Huriez, Lille, France Hopital Europeen Georges Pompidou, Paris, France Departement d’Oncologie, CHC Clinique Saint Joseph, Liege, Belgium Service de Gastroenterologie, Hopital Rangueil, Toulouse Cedex 9, France INSERMUMR 776, Medical Oncology Unit, Paul Brousse Hospital, Villejuif, France Medical Oncology Unit, Hospital Fernando Fonseca, Amadora, Portugal UO Oncologia Azienda Ospedaliera S.Maria degli Angeli Pordenone, Pordenone, Italy Medical Oncology Unit Hopital Huriez, Lille, France Hepato-Biliary centre, Hopital Paul Brousse, Villejuif, France Institut Gustave Roussy, Villejuif, France Hopital Europeen Georges Pompidou, Paris, France Paul Brousse Hospital, Villejuif, France AP-HP Hopital Paul Brousse, Villejuif, France Introduction: Less than 15% of the patients (pts) with previously unresectable colorectal cancer (CRC) liver metastases (LM) and prior chemotherapy undergo successful complete macroscopic LM resection (R0-R1). Here, we determine Overall Survival (OS) in pts undergoing R0-R1 partial hepatectomy after second line hepatic artery infusion (HAI) with Irinotecan, 5-Fluorouracil and Oxaliplatin (IFO), and intravenous cetuximab (IV-CET) for LM-CRC in the first multicenter European trial testing this strategy.

AIM: To determine imatinib nonadherence rates in patients with gastrointestinal tumors (GIST) over 90 days. PATIENTS AND METHODS: A prospective 90-day observational, open-label, multicenter study was carried out of 28 evaluable GIST patients on imatinib. Nonadherence behavior was measured using a 4-item patient interview. Clinicians, patients, and collaterals rated perceived patient adherence on a 0-100 VAS scale. RESULTS: Nonadherence rates in the 4 weeks prior to baseline and follow-up were 29% (95% CI=26-32) and 24% (95% CI=21-27, p>0.05). Mean VAS ratings of perceived adherence ranged from 95.2 ± 10.2 to 97.3 ± 4.8 (p>0.05 for time and source of rating). Correlations between perceptions of and actual adherence behavior were negative. CONCLUSION: In this first study on imatinib nonadherence in GIST patients, rates were similar to those observed in patients with chronic myeloid leukemia, higher than clinically expected and exceeding meta-analytic estimates for cancer. Nonadherence rates were consistent across the 90-day period. Nonadherence behavior should be assessed by clinicians.