No abstract

16037 Background: Evidence-based Oncology (EBO) is founded in clinical trials, medical expertise and patient’s quality of life. Pts with MPC are excluded from clinical trials and there is a lack of clinical expertise as regards to these cases. With the aim to analyze the clinical reasoning for treatment recommendation on those pts, we interviewed oncologists in charge (doc’s) at Instituto Oncológico Henry Moore (IOHM) and Universidad del Salvador (USAL). Methods: The medical records of 8,500 pts from IOHM’s database over last eight years (1997–2005) were reviewed in order to measure the incidence and characteristics of MPC pts. A total of 35 oncologists in charge were identified and participated on a survey which had ten points. The 10 items should be ranked in order of importance: 1 = the most important one and 10 = the least one. Results: One hundred and seventy eight MPC pts (2.09%) were detected, and the oncologist in charge was asked to complete the survey. All doc’s completed the survey. The following table shows the rank and the scoring for each item. (See table below) Conclusions: Four domains ( I to IV) in medical decision making for the treatment of MPC pts were identified: I = PS; II = Characteristics of the tumor; III = Morbidity from therapy and IV = Pt preferences. The pt and family preferences were ranked in the last place and it could reflect a paternalistic approach. To our understanding, this is a good model to test clinical skills and biases in medical treatment selection. [Table: see text] No significant financial relationships to disclose.

19657 Background: Hormonotherapy (H) is the most widely used treatment against breast cancer (BC). The aim of this study is a prospective evaluation with an enriched the SF-36 questionnaire, of the QOL of BC patients (pt) treated with H at the IOHM. Specific questions regarding menopausal symptoms and body weight were added. Methods: Between Aug 2005 and Nov 2006, all pt that were undergoing H, were requested to fill out a SF-36 self-evaluation form. The SF-36 is a multi-purpose, short-form health survey, with 36 questions about functional health and well-being. The answers were tabulated. The pre-treatment and post-treatment body weight of each pt was registered. Results: Three Hundred and Twenty-six pt were invited to participate, and all of them accepted, and signed a consent form. Characteristics of the population: Diagnosis: DCIS: 36 pt; LCIS: 5 pt; IDC 250 pt; ILC: 35 pt. All cases expressed hormonal receptors. The H was adjuvant in 254 pt (78%) mostly treated with T and palliative in 72 pt (22%) mostly treated with AI. Median age was 62 years, however 63 pt (19%) were pre-menopausal. The median time under treatment was 33 months (range 1–71 m). The pt reported: General evaluation of Quality of life: Very good or excellent: 154 pt (47%) , Good: 134 pt (41%), Poor: 34 pt (11%). Severe limitations for demanding physical activities: 43 pt (13 %). A reduction of time spent on the job: 66 pt (22%). Severe pain during the last four weeks prior to answering the questionnaire: 24 pt (8 %). Weight increase perception: 153 pt (47%). Actual increase of weight: 192 pt (60%) (Median: 4 kg). Menopausal symptoms: Daily Hot Flushes: 132 pt (40%). Vaginal discharge 110 pt (33%) Decrease of libido: 98 pt (30%), Vaginal dryness 76 pt (23%), Nightly sweats: 40 pt (12%). Sixty pt (18%) suffered from and received treatment for menopausal symptoms. Conclusions: 1) The SF-36 is a useful tool to measure the BC patients’ quality of life 2) Although in our cohort most of the patients (88,3%) rated their general QOL as “good to very good”, a third of the pt presented severe menopausal symptoms, and 18% received non hormonal medication for symptoms relief 3) Sixty percent of the pt had a median body weight gain of 4 Kg. No significant financial relationships to disclose.

e17535 Background: Juvenile Cancer (JC) involves patients between 18 and 29 years old (adult pt less than 30 yo) and can be or not associated to AIDS. The non-AIDS JC pt challenge the clinical oncologist in many ways: there are few preventive measures, avoiding delayed toxicities is mandatory (fertility, cognitive impairment) and there is a lack of evidence-based treatments for uncommon tumors. The aim of this paper is to evaluate the incidence and clinical outcome of JC non AIDS related at the IOHM. Methods: A JC search in the patient database of the IOHM was made. The inclusion criteria was: new cancer pt diagnosed between 18 and 29 yo. The following variables were analyzed: age, gender, date, absolute and relative annual incidence and diagnosis. The tumors were classified as expected (germinal, hematological, sarcoma, melanoma, CNS, thyroid, cervix, trophoblastic disease) or unexpected (breast, colon, ovarian, gastric, pancreatic, head and neck). The Mean Annual New Case (MANC) incidence for pt older than 30 yo (non-JC) and JC in two different four year periods (“A”: 2001–2004, “B”: 2005–2008) were calculated in order to analyze the relative risk between both populations for these periods. Results: A total of 12.828 new pt were managed at the IOHM between January 2001 and January 2008, with 336 of them (2.6%) being JC. Mean age (range) = 23.3 years (18–29). Gender: male = 180 (53%) and female = 156 (47%). Diagnosis: Expected tumors 269 pt (80%) (testicular tumors = 89 pt; lymphoma = 75 pt; sarcoma = 35 pt; melanoma = 17 pt; others = 53), Unexpected tumors 67 pt (20%) (gastrointestinal = 23 pt; breast cancer = 17 pt; ovarian = 13 pt; head and neck = 7 pt; others = 7 pt). MANC for Non JC in A=1458.25 pt/y; MANC for Non JC in B = 1748.75 pt/y (RR Non JC B/A = 1.2). MANC JC in A = 18.5 pt/y; MANC JC in B = 52.75 pt/y (RR JC B/A = 2.85). Conclusions: 1) In our database, 336 cases of JC out of 12.828 new cancer patients between were found 2001 and 2008; 2) Expected tumors represent 80% of the cases; 3) An unexplained trend of new cases of JC is seen in this 8-year period. The comparison of the first 4 years and the second 4 years shows a relative risk increase of 300% of cases in this population. If other investigators confirm this data, a severe public health problem may be unrecognized. No significant financial relationships to disclose.