The 2021 Annual Conference of the International Society of Geriatric Oncology (SIOG) was held on November 4–5. Although participants could not join the conference in person, attendees could still stay informed about the latest developments in geriatric oncology through the virtual platform.
The theme of the SIOG Annual Conference was “Geriatric Oncology: The Past, Present, and Future.” There were 135 oral presentations spread across 29 scientific sessions and 172 e-posters. Despite being a virtual conference, SIOG 2021 engaged 445 participants, which was comparable to attendance at past conferences.
The conference had several program highlights: “rapid-fire updates” in medical hematology-oncology, radiation, and surgery; joint sessions with international societies (Nursing and Allied Health Interest Group/Canadian Association of Nurses in Oncology/European Oncology Nursing Society, European Society for Medial Oncology, European Society of Surgical Oncology, Multinational Association of Supportive Care in Cancer); multidisciplinary team sessions, in which difficult cases were discussed by experts in different specialties; geriatric assessment workshops; and abstract sessions.
Surgery Updates
The surgical session was highlighted by the presentation of results of the GOSAFE study by Isacco Montroni, MD, PhD, of the Ospedale per gli infermi, Italy. GOSAFE was a prospective, multicenter, observational study that evaluated the trajectory of quality of life and functional recovery of elderly patients after cancer surgery, measured at baseline, at 3 months, and at 6 months postsurgery. Frailty was detected by a score ≤ 14 on the Geriatric-8 (G8) screening tool (68.4%), a score ≥ 2 on the Flemish version of the Triage Risk Screening Test (fTRST; 37.4%), or an American Society of Anesthesiologists score of 3 or 4 (48.8%).
The 3-month mortality for patients in the study was low (< 5%). Factors associated with 3-month mortality on univariate analysis included Charlson Age Comorbidity Index (CACI) score ≥ 7, moderate or severe nutritional impairment, grade III or IV complications, and open surgery (vs minimally invasive surgery). Factors associated with 3- and 6-month quality of life were fTRST score ≥ 2, palliative surgery, history of delirium, and grade III or IV complications.
Among the 504 patients who underwent colorectal surgery, 71% had complete functional recovery 6 months after surgery. A CACI score ≥ 7, history of delirium, open surgery, palliative intent, and grade ≥ III or IV complications were associated with functional decline after an operation. The study demonstrated that neither cancer type nor age influenced quality of life, but grade III or IV complications did.
Nicola de’ Liguori-Carino, MD, of Manchester Royal Infirmary, University of Manchester, United Kingdom, presented a talk on the benefits of prehabilitation and rehabilitation of older adults before and after cancer surgery. The Prehab4Cancer program was initiated in April 2019 in Manchester, focusing on three themes: exercise, nutrition, and well-being. More than 40% of the participants in the program were aged 70 or older.
The Prehab4Cancer program showed that age was not a limiting factor for physical activities. Moreover, the benefits of prehabilitation and rehabilitation included shortened recovery, reduced treatment-related complications, improved adherence and completion of treatment, and improved quality of life.
GUEST EDITOR
Geriatrics for the Oncologist is guest edited by Stuart M. Lichtman, MD, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Dr. Lichtman is Professor of Medicine, Weill Cornell Medical School; Attending, Memorial Sloan Kettering Cancer Center; and Past President, International Society of Geriatric Oncology (2016–2018). For more information about geriatric oncology, visit www.siog.org and the ASCO Geriatric Oncology website (www.asco.org/practice-guidelines/cancer-care-initiatives/geriatric-oncology/geriatric-oncology-resources).Hematology Updates
Smith Giri, MD, of the University of Alabama at Birmingham, performed a systematic review and searched seven bibliographic databases for studies on the impact of sarcopenia among adults with hematologic malignancies. The review included 26 studies with 4,680 patients; 16 of those studies demonstrated an association between sarcopenia and inferior survival. The presence of sarcopenia was associated with worse overall survival (hazard ratio [HR] = 1.59, 95% confidence interval [CI] = 1.21–2.09, P = .001) and worse progression-free survival (HR = 1.78, 95% CI = 1.35–2.34, P < .001), with significant evidence of heterogeneity (Cochran’s Q, I2 = 83.9%; Cochran’s Q, I2 = 73.2%, respectively). In addition, sarcopenia was associated with worse nonrelapse mortality (HR = 1.72, 95% CI = 1.34–2.22, P < .001), however, with little evidence of heterogeneity (Cochran’s Q, I2 = 0.0%).
Medical Oncology Updates
Jessica Pearce, MD, of the University of Leeds, United Kingdom, presented a retrospective review to assess the association between frailty and cancer treatment outcomes in patients with advanced gastroesophageal cancer. The study included 514 patients commencing first-line palliative chemotherapy for advanced disease. Their baseline frailty was measured by ECOG performance status, the GO2 frailty score (GO2FS), G8 score, Cancer and Aging Research Group (CARG) toxicity score, and a modified Rockwood Clinical Frailty Scale (mCFS) score.
Frailty identified via the GO2FS, mCFS, and G8 tools conveyed a statistically significant increased risk of worse treatment outcome in older and frail younger patients with advanced gastroesophageal cancer, with adjusted odds ratios of 1.19 (1.06–1.33), 1.14 (1.02–1.27), and 0.91 (0.85–0.97), respectively. The study demonstrated that frailty measures added information over and above performance status in predicting treatment outcomes in patients with advanced gastroesophageal cancer.
Other Topics
The 2021 SIOG Annual Conference covered a wide range of additional topics. The Young SIOG committee and SIOG Nurses and Allied Health Professionals made valuable contributions to the conference. In the Young SIOG session, Kah Poh (Melissa) Loh, MBBCh, BAO, and Erika Ramsdale, MD, both of the University of Rochester, New York, and Enrique Soto Pérez de Celis, MD, MSc, of Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, presented on the use of the latest technology in supporting older adults with cancer and how machine learning and artificial intelligence have helped in research.
The next SIOG Annual Conference will be held October 28–30, 2022, in Geneva. For more information, visit www.siog.org.
Dr. Chan is Clinical Assistant Professor in the Department of Clinical Oncology at The University of Hong Kong.
DISCLOSURE: Dr. Chan and Dr. Lichtman reported no conflicts of interest.
Acknowledgment: The author thanks Ms. Gobby Kwong Wing-tung for her help in the preparation of the manuscript.
