Predictors of Noncompletion of Cancer Treatments in Elderly Patients: the Elderly Cancer Patients (Elcapa) Cohort Study

ABSTRACT Background The objective was to assess 1) prevalence and the predictors of non-completion of cancer treatments in elderly and 2) prognosis value of noncompletion of cancer treatments. Methods Between 2007-2010, 421 consecutive patients aged 70 years and older with solid tumors and indication of surgery, chemotherapy (CT), hormonal therapy (HT) or radiotherapy (RT) were included. Comprehensive Geriatric Assessment was performed at baseline. Patients were followed up for completion of surgery, first line CT (observed/expected number of cycles  Results Mean age was 79.2 years (±5.4) years and 224 patients (53.2%) were women.190 (45. 1%) had gastro-intestinal, 109 (25.9%) gynaecologic and 97 (23%) genitor-urinary primary tumors.192 (45.6%) had metastatic disease. 76 (33.8%) received platinum-based therapy. • Rate of noncompletion was 39.1 % for CT versus 6.5 %, 3.5 % and 2.4 % for HT, surgery and RT respectively. In multivariate analysis, predictors of noncompletion of CT were: poor performance status (PS ≥ 2) : OR = 2.1, 95 %CI, [1.06-4.17], p = 0.03, (or Activity of Daily Living (ADL): OR 1 point decrease= 1.5, [1.1-2.0], p= 0.024), decreased renal function: OR 1 ml/min decrease Cockcroft clearance = 1.02, [1-1.03],p= 0.009 and living alone :OR = 1.9, [1-3.6], p = 0.05. One year rate of mortality was 26.2 %. Independant prognostic factors for survival were noncompletion of CT: HR = 3.6, [2.2-6], p  Conclusion In the elderly with solid tumors, noncompletion of CT was common whereas HT, RT and surgery were not. Predictors of noncompletion of CT are poor functional status, decreased renal function and living alone. Noncompletion of CT is an independent prognostic factor for survival. Disclosure All authors have declared no conflicts of interest.