Author of

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  P09 - Health Services Research/Health Economics - Real World Outcomes (ID 121)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Health Services Research/Health Economics
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35080

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    P09.32 - Is the New Patient Respiratory Appointment an Appropriate Time to Refer Patients With Likely Lung Cancer for Prehabilitation? (ID 2953)

    00:00 - 00:00  |  Presenting Author(s): Lauren Glanville
    • Abstract
    • Slides

    Introduction
    

    Patients with lung cancer are often co-morbid¹ with high symptom burden.² Lung cancer treatments are increasing in intensity and duration. Prehabilitation provides an opportunity to improve outcomes for patients.³

    We completed a feasibility study to ask the following:

    1. Would possible cancer on a CT scan in a patient fit for further investigation be appropriate screening criteria for prehabilitation referral?

    2. Was the time between CT scan and starting anti-cancer treatment sufficient to commence prehabilitation?

    Methods
    

    24 consecutive patients attending urgent respiratory clinics with possible lung cancer were recruited between October and November 2019. Patients’ general fitness was assessed by: PG-SGA (Patient Generated Subjective Global Assessment), G8 frailty assessment and patient reported performance status. Following the clinic CT scan reports were reviewed, we included as high risk all scans that implied or explicitly stated likely lung cancer (eg suspicious, concerning, favour).

    Results
    

    24 patients (13:M, 11:F) were recruited; median age 72 years (range 47-89). All patients approached consented to involvement.

    15/24 had high suspicion of cancer on CT. Of the 8 patients suitable for further investigation, 7 had confirmed histological diagnosis of lung cancer. 4 patients were not fit enough for further investigation, 2 remain under follow up and 1 had an alternative diagnosis confirmed.

    6 were referred to oncology. Time between first respiratory and first oncology clinic appointments varied from 13 to 62 days. At initial respiratory appointment 5 of these patients PG-SGA score was >4 (need for intervention). 5 patients self rated performance status 0-2, 1 patient reported as 3. All had a G8 frailty score <14 (abnormal).

    

    Conclusion
    

    1. A CT scan suspicious for cancer in patients fit for further investigation identified 87.5% (7/8) of those with subsequently confirmed lung cancer. These are appropriate criteria for prehabilitation referral.

    2. Referring patients when likely lung cancer is indentified on CT allows adequate time for intervention, including in the shortest time to oncology (13 days).

    3. 83% (5/6) required dietetic input, 100% (6/6) scored low on the G8 assessment and 83% (5/6) self assessed PS 0-2.

    References:
    1. Gould MK et al. Comorbidity profiles and their effect on treatment selection and survival among patients with lung cancer. Ann Am Thorac Soc 2017;14(10):1571-1580

    2. Phillips I et al. Symptom burden strongly correlates with the need for a dietician in advanced NSCLC. 18^th annual BTOG/ Lung Cancer 2020:139(1):S79-S80

    3. Giles C, Cummins S. Prehabilitation before cancer treatment. BMJ 2019;366:l5120

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