- •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.
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.
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.
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).
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.
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- The elderly patient with cancer: a holistic view.Nutrition. 2015; 31: 587-589
- International Society of Geriatric Oncology Consensus on geriatric assessment in older patients with cancer.J Clin Oncol. 2014; 32: 2595-2603
- An update on a systematic review of the use of geriatric assessment for older adults in oncology.Ann Oncol. 2014; 25: 307-315
- Predictors of 1-year mortality in a prospective cohort of elderly patients with cancer.J Gerontol Ser A, Biol Sci Med Sci. 2015; 70: 1148-1155
- Use of a comprehensive geriatric assessment for the management of elderly patients with advanced non-small-cell lung cancer: the phase III randomized ESOGIA-GFPC-GECP 08-02 study.J Clin Oncol – Off J Am Soc Clin Oncol. 2016; 34: 1476-1483
- The impact of comprehensive geriatric assessment interventions on tolerance to chemotherapy in older people.Br J Cancer. 2015; 112: 1435-1444
- Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations.Ann Oncol – Off J Eur Soc Med Oncol/ESMO. 2015; 26: 288-300
- Screening for vulnerability in older cancer patients: the ONCODAGE prospective multicenter cohort study.PLoS One. 2014; 9: e115060
- Screening older cancer patients: first evaluation of the G-8 geriatric screening tool.Ann Oncol. 2012; 23: 2166-2172
- The G8 screening tool detects relevant geriatric impairments and predicts survival in elderly patients with a haematological malignancy.Ann Hematol. 2014; 93: 1031-1040
- Optimizing the G8 screening tool for older patients with cancer: diagnostic performance and validation of a six-item version.Oncologist. 2016; 21: 188-195
- CART: Stata module to perform classification and regression tree analysis.in: Statistical Software Components S456776. Boston College Department of Economics, 2006
- Performance of two geriatric screening tools in older patients with cancer.J Clin Oncol. 2014; 32: 19-26
- Predictors of early death risk in older patients treated with first-line chemotherapy for cancer.J Clin Oncol. 2012; 30: 1829-1834
- Predictive value of geriatric assessment for patients older than 70 years, treated with chemotherapy.Crit Rev Oncol Hematol. 2011; 79: 205-212
- Prognostic value of geriatric assessment in older patients with advanced breast cancer receiving chemotherapy.Breast. 2013; 22: 753-760
- Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: a prospective observational cohort study.Crit Rev Oncol Hematol. 2010; 76: 208-217
- Self-rated current and future health independently predict subsequent mortality in an aging population.J Gerontol A Biol Sci Med Sci. 2007; 62: 1428-1434
- Physical performance measures for predicting outcome in cancer patients: a systematic review.Acta Oncol. 2016; 55: 1386-1391
- Screening for frailty among older patients with cancer that qualify for abdominal surgery.J Geriatr Oncol. 2015; 6: 52-59
- Screening older cancer patients for a comprehensive geriatric assessment: a comparison of three instruments.J Geriatr Oncol. 2011; 2: 121-129
- G-8 indicates overall and quality-adjusted survival in older head and neck cancer patients treated with curative radiochemotherapy.BMC Cancer. 2015; 15: 875
- Identification of clinical parameters predictive of one-year survival using two geriatric tools in clinically fit older patients with hematological malignancies: major impact of cognition.J Geriatr Oncol. 2015; 6: 362-369
- Risk factors for excess mortality in the first year after curative surgery for colorectal cancer.Ann Surg Oncol. 2012; 19: 2428-2434
- Importance of the first postoperative year in the prognosis of elderly colorectal cancer patients.Ann Surg Oncol. 2011; 18: 1533-1539
- PPT and VES-13 in elderly patients with cancer: evaluation in multidimensional geriatric assessment and prediction of survival.J Geriatr Oncol. 2014; 5: 415-421
- Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer.J Geriatr Oncol. 2013; 4: 32-38
- The Flemish version of the Triage Risk Screening Tool (TRST): a multidimensional short screening tool for the assessment of elderly patients.Crit Rev Oncol Hemat. 2006; 60 (S31–S31)
- Diagnostic performance of gait speed, G8 and G8 modified indices to screen for vulnerability in older cancer patients: the prospective PF-EC cohort study.Oncotarget. 2017 Apr 21; ([Epub ahead of print])https://doi.org/10.18632/oncotarget.17361
Published online: July 24, 2017
Accepted: June 21, 2017
Received in revised form: June 16, 2017
Received: April 6, 2017
© 2017 Elsevier Ltd. All rights reserved.