Cancer patients admitted to geriatric rehabilitation in the Netherlands: A nationwide database study

Dr Ilse Pluim, geriatrician in training at Amsterdam UMC, the Netherlands presented the results of a nationwide descriptive study in cancer patients admitted to geriatric rehabilitation facilities in the Netherlands, with a specific focus on differences between those admitted to dedicated oncogeriatric rehabilitation (OncoGR) units and those admitted to other forms of geriatric rehabilitation while having an active cancer diagnosis. Using a nationwide database, they aimed to describe patient characteristics, care delivery, and prognosis in both groups, and to explore implications for patient selection and referral practices.

The analysis demonstrated that a substantial proportion of older patients with cancer undergoing geriatric rehabilitation are not admitted to specialised OncoGR units. In fact, this group was almost twice as large as the cohort admitted to dedicated oncogeriatric rehabilitation. Despite the shared diagnosis of cancer, clear differences were observed in the type and intensity of care provided. Patients admitted to OncoGR units received more specialised and complex nursing care, had more frequent involvement of dietitians, and were more likely to receive psychosocial and spiritual support, including chaplaincy care. These findings reflect the specialised focus of OncoGR units on managing the complex medical, functional, and supportive care needs of patients with cancer.

Survival outcomes revealed high mortality rates in both groups, with particularly poor prognosis among patients admitted to OncoGR. More than 50% of these patients died within one year of admission, and approximately 10% died within the first month. Although outcomes were somewhat better among patients admitted to non-specialised geriatric rehabilitation units, mortality remained considerable, with 36% dying within one year and 6% within one month of admission. These data indicate that patients referred to geriatric rehabilitation with a cancer diagnosis represent a highly vulnerable and frail population, especially those selected for specialised oncogeriatric programs.

The observed mortality rates raise important questions regarding current referral and admission practices. The findings suggest that oncogeriatric rehabilitation may predominantly be offered to very frail patients with advanced disease, potentially at a stage when the likelihood of meaningful functional recovery is limited. Conversely, less frail patients with cancer, who might benefit more from timely and intensive rehabilitation, may be underrepresented in both OncoGR and general geriatric rehabilitation settings.