WP 1.2: Perioperative Comprehensive Geriatric Assessment and tailored intervention in older, frail patients with muscle invasive bladder cancer scheduled for radical cystectomy (COMPETENCE-study)
Jun 28, 2022
The aim of the study is to examine the effect of a perioperative Comprehensive geriatric assessment (CGA), tailored interventions, and implementation of an inter- and multidisciplinary collaboration in older, frail patients with muscle invasive bladder cancer (MIBC) and scheduled for radical cystectomy.
Patients with MIBC are often older, multimorbid, and possible frail, thus in increased risk of perioperative mortality and morbidity. Frailty can potentially be modified. CGA identifies patient-specific problems and initiate relevant interventions to optimize health status and improve treatment tolerability. Limited evidence exists in relation to surgical cancer treatment.
In total, 140 patients ≥65 years and considered frail by the G8 frailty screening tool, will be included in this nationwide randomised controlled trial. Patients will be randomised 1:1 to either control group with “standard care” or intervention with preoperative CGA followed by tailored interventions, and postoperative geriatric ward rounds. Primary outcome will be Days Alive Out of Hospital 90 days postoperatively. Secondary outcomes will be complications (Clavien-Dindo Grade III-V and Comprehensive Comorbidity Index (CCI)) 30 and 90 days, mortality, hospital readmissions, Length of stay (LOS), Quality of Life (EQ-ED-5L and EORTC C30). Finally, we will also evaluate the cost-effectiveness. Older frail patients are often excluded in studies, but as numbers of older people are expected to increase remarkably in the next 30 years, further knowledge on this fragile group is essential.
Results could have a significant positive impact on cancer treatment and health-related quality of life for each patient.
Awarded to: Jørgen Bjerggard Jensen (AUH) – CFA1
Awarded grant to support TAP personnel.
