Factors leading oncologists to refer elderly cancer patients for geriatric assessment

Objectives: We characterized elderly cancer patients referred to an oncogeriatric unit and sought factors warranting referral for geriatric assessment before or during cancer therapy. Materials and methods: We reviewed the files of all consecutive elderly patients seen from October 2006 to April 2008 in our primary-care oncogeriatric unit. All subjects had a comprehensive geriatric assessment. Patients evaluated before oncologic decision-making were compared to those evaluated after cancer therapy had started. Results: We studied 65 patients with a median age of 82.4 years (range 71-95). The most frequent malignancies were breast (29.0%), lung (24.6%) and colorectal tumors (7.6%). Thirty-nine patients (60%) had metastatic disease. One-quarter of patients had one or more disabilities on the Activities of Daily Living scale, more than half (53.8%) were classified as. dependent on the Instrumental Activities of Daily Living scale, and nearly half (45.3%) had cognitive dysfunction. Thirty-five patients were evaluated before oncologic decision-making and thirty during cancer treatment. Recent weight loss > 10% (32.3% vs 15.3%; p = 0.031) was more frequent among patients who had a geriatric assessment before cancer therapy. These latter patients were also taking fewer drugs (4.8 vs 6.1; p = 0.036) and were more likely to receive adjusted cancer therapy (41.5% vs 26.1%; p = 0.051). Conclusion: Weight loss was the main feature leading oncologists to refer elderly cancer patients for geriatric assessment. Patients who had a geriatric assessment before oncologic decision-making were more likely to receive adjusted cancer therapy. (C) 2011 Elsevier Ltd. All rights reserved.