Page 181 - Risk quantification and modification in older patients with colorectal cancer

of normal-dose chemotherapy or (extensive) surgical treatment) or if no oncologic treatment was recommended (‘supportive care only’).
Statistical analysis
The statistical program IBM SPSS for Windows, version 23.0 (SPSS, Inc., Chicago, IL, USA) was used for the statistical analyses. For comparisons between groups, the Chi-square test was used for nominal and ordinal variables, the Anova test for continuous variables. A p-value of <0.05 was considered statistically significant.
Results
The total number of included referrals was 168. Of these, 76 patients (45%) were from the Diakonessenhuis hospital, 62 (37%) from the Hagaziekenhuis and 30 patients (18%) from the Elisabeth-Tweesteden hospital. The median age was 81 years (range 60-94) and 51% were male (Table 1). A total of 45% had a Charlson comorbidity index of ≥2 and 69% used five or more medications. The majority of patients (71%) were diagnosed with colon cancer, the other 29% had rectal cancer. Almost half of the patients had stage III disease.
Geriatric consultations
The reason for geriatric consultation was uncertainty regarding the optimal oncologic treatment in 139 patients (83%). The remainder (17%) already had a final treatment plan: they were referred for optimisation prior to the oncological treatment. Most patients were referred by a gastroenterologist (59%) or a colorectal surgeon (33%). The majority (85%) was seen in the out-patient clinic.
Overall, 93% of patients had one or more geriatric impairments. Most common impairments were polypharmacy (57%), impaired mobility (38%) and comorbidity (38%, Table 2). Non-oncological interventions that followed after geriatric consultation were mostly aimed at malnutrition, social network, psychological and cognitive disorders.
Advanced care planning considerations were mentioned in the charts of 55 patients (33%). Clarification of patient’s priorities was required for 43 patients (26%) and erroneous treatment expectations were corrected in 40 patients (24%).
CGA and treatment decisions
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