Dados do Trabalho

Título

COMPREHENSIVE GERIATRIC ASSESSMENT AS A TOOL IN PATIENTS WITH NEOPLASIA OF THE GASTROINTESTINAL TRACT IN A UNIVERSITY HOSPITAL.

Introdução

The WHO defines an elderly person as an individual aged 60 years or over. A multidimensional evaluation has become necessary for the diagnosis of the clinical and functional demands . The CGA (Comprehensive Geriatric Assessment) is intended to supply such deficiencies . A review of specialized literature highlights the ability of CGA to predict functional decline, estimate survival and even assist the physician in decision making

Objetivo

This study aims to evaluate the population over 60 years of age of patients that receive chemotherapy for gastrointestinal cancer (GIC). The baseline categorical variables assessed belong to the CGA such as functionality and nutritional status in focus in this partial analysis.

Método

This is a prospective clinical ongoing study. Inclusion criteria : GIC confirmed by anatomopathological study; any gender; age greater than or equal to 60 years; patients who will start chemotherapy. The CGA was applied at the beginning of the treatment of patients followed for a period of 3 months. The study had been approved by a local committee and all the patients signed a written free consentment.

Resultado

19 patients have been included. The mean and median age are respectively 65.2 and 65.5y. 8 were 70y or older. The tumor sites were: 6 with colon, 3 with rectal, 2 with stomach, 2 with esophageal, 5 with pancreas and 1 with biliary tract cancer. The predominant histology was adenocarcinoma. For all patients chemotherapy was proposed. CGA was applied at beggining. The instrument validated for functionality and nutritional assessment were the Barthel Scale and the Mini Nutritional Assessment . 4 had a mild and 2 a moderate degree of dependence. For the initial nutritional assessment 12 were at risk of malnutrition and 5 were malnourished. In 3-month period: 1 did not start treatment due to stroke; 2 had treatment interrupted due to loss of clinical performance after 2 months; 2 deaths by sepsis and venous thromboembolism; 14 followed with acceptable toxicity. Treatment break associated with poor nutritional status.

Conclusão

The CGA becomes an important tool to predict outcomes in this age group. The importance of nutritional assessment is highlighted . Mild and moderate dependence was observed in 32% of the patients. Although 26% had unfavorable outcomes, most of them had been treated with accepted toxicity in a 3-month period.

Palavras-chave

elderly patients, oncogeriatrics, gastrointestinal tract neoplasms