Factors leading oncologists to refer elderly cancer patients for geriatric assessment

ObjectivesWe characterized elderly cancer patients referred to an oncogeriatric unit and sought factors warranting referral for geriatric assessment before or during cancer therapy.Materials and methodsWe 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.ResultsWe 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).ConclusionWeight 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.