Highlights
- •We compared the prognostic value of 2 screening tools in older patients with cancer.
- •They help to better identify older cancer patients requiring a geriatric assessment.
- •Both scores showed good prognosis value for overall 1- and 3-year survival.
- •The associations persisted after stratifying by metastatic status and cancer site.
- •This supports the clinical utility of both tools in the geriatric oncology setting.
Abstract
Background
The G8 screening tool has been developed to identify older cancer patients requiring
a geriatric assessment for tailoring therapy. Little is known about its prognostic
value, particularly by tumour site. An optimised version has been recently developed,
but no prognostic information is available. We compared the prognostic value of both
instruments overall and by tumour site.
Methods
Data were from a prospective cohort of cancer patients ≥70 years old referred to 1
of 6 French geriatric oncology clinics between 2007 and 2014 (n = 1333). Endpoints
were overall 1- and 3-year survival. Cox proportional-hazards models were built to
assess the predictive value of abnormal G8 and modified-G8 scores, based on published
cut-offs or by classes of increasing risk. Sensitivity analyses involved adjusting
for age, gender, treatment, metastasis, and tumour site (digestive, breast, urinary
tract, prostate, other solid cancers, and haematological malignancies) and stratifying
by tumour site and metastatic status.
Results
Abnormal scores were independently associated with overall 1-year survival: adjusted
hazard ratio [aHR] = 4.3[G8]/4.9[modified-G8] and 3-year survival: aHR = 2.9/2.6;
all p <0.0001. Associations persisted after stratifying by metastatic status and in most
cancer sites (exceptions: colorectal (G8) and upper digestive cancer (both tools)
[1-year analysis]; digestive cancers (both tools) [3-year analysis]). For both tools,
classes of increasing risk showed a graded relationship with mortality (p < 0.0001).
Conclusions
Our results identified both abnormal G8 and modified-G8 scores as strong and consistent
predictors of overall survival, regardless of metastatic status or tumour site. These
findings strengthen the clinical utility of these instruments in the geriatric oncology
setting.
Keywords
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Article info
Publication history
Published online: July 24, 2017
Accepted:
June 21,
2017
Received in revised form:
June 16,
2017
Received:
April 6,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
