Prognostic value of the G8 and modified-G8 screening tools for multidimensional health problems in older patients with cancer

2017 ◽  
Vol 83 ◽  
pp. 211-219 ◽  
Author(s):  
Claudia Martinez-Tapia ◽  
Elena Paillaud ◽  
Evelyne Liuu ◽  
Christophe Tournigand ◽  
Rima Ibrahim ◽  
...  
Keyword(s):  
Older Patients ◽  
Prognostic Value ◽  
Health Problems ◽  
Screening Tools ◽  
Patients With Cancer ◽  
Multidimensional Health

Performance of Two Geriatric Screening Tools in Older Patients With Cancer

2014 ◽  
Vol 32 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Cindy Kenis ◽  
Lore Decoster ◽  
Katrien Van Puyvelde ◽  
Jacques De Grève ◽  
Godelieve Conings ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Prognostic Value ◽  
Functional Decline ◽  
Treatment Decision ◽  
Risk Profile ◽  
Screening Tools ◽  
Patients With Cancer ◽  
Geriatric Screening

Purpose To compare the diagnostic characteristics of two geriatric screening tools (G8 and Flemish version of the Triage Risk Screening Tool [fTRST]) to identify patients with a geriatric risk profile and to evaluate their prognostic value for functional decline and overall survival (OS). Patients and Methods Patients ≥ 70 years old with a malignant tumor were included if a new cancer event occurred requiring treatment decision. Geriatric screening with G8 and fTRST (cutoff ≥ 1 [fTRST (1)] and ≥ 2 [fTRST (2)] evaluated) was performed in all patients, as well as a geriatric assessment (GA) evaluating social situation, functionality (activities of daily living [ADL] + instrumental activities of daily living [IADL]), cognition, depression, and nutrition. Functionality was re-evaluated 2 to 3 months after cancer treatment decision, and death rate was followed. Functional decline and OS were evaluated in relation to normal versus abnormal score on both screening tools. Results Nine hundred thirty-seven patients were included (October 2009 to July 2011). G8 and fTRST (1) showed high sensitivity (86.5% to 91.3%) and moderate negative predictive value (61.3% to 63.4%) to detect patients with a geriatric risk profile. G8 and fTRST (1) were strongly prognostic for functional decline on ADL and IADL, and G8, fTRST (1), and fTRST (2) were prognostic for OS (all P < .001). G8 had the strongest prognostic value for OS (hazard ratio for G8 normal v abnormal, 0.38; 95% CI, 0.27 to 0.52). Conclusion Both geriatric screening tools, G8 and fTRST, are simple and useful instruments in older patients with cancer for identifying patients with a geriatric risk profile and have a strong prognostic value for functional decline and OS.

Prognostic value of routine biomarkers in older patients with cancer: Pooled analysis of three prospective cohorts.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11551-11551
Author(s):  
Elena Paillaud ◽  
Pierre Soubeyran ◽  
Nadia Oubaya ◽  
Etienne Brain ◽  
Marianne Fonck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Older Patients ◽  
Prognostic Value ◽  
Prognostic Score ◽  
Performance Status ◽  
Glasgow Prognostic Score ◽  
Pooled Analysis ◽  
Clinical Model ◽  
Patients With Cancer ◽  
Net Reclassification Improvement

11551 Background: To assess prognostic value of routine biomarkers in older patients with cancer. Methods: A pooled analysis of three prospective multicentre cohorts, ELCAPA, PHRC Aquitaine and ONCODAGE was conducted. Patients aged 70 years or older, with cancer were included. Biomarkers collected were plasmatic C-reactive protein, albumin and a combined score: Glasgow Prognostic Score (GPS). The GPS comprised three categories (0: CRP≤10 mg/L, albumin≥35 g/L; 1: CRP≤10 mg/L and albumin < 35 g/L, or CRP > 10 mg/L and albumin≥35 g/L; 2: CRP > 10 mg/L and albumin < 35 g/L).The primary endpoint was overall survival at 12 months. Multivariable Cox models were used, adjusting for age, sex, localisation, metastatic status, performance status, frailty screening index, the G8. Discriminative properties were assessed using Harrell C index and NRI (Net Reclassification Improvement). Results: Overall 1800 patients were analyzed (ELCAPA: N = 543, PHRC Aquitaine: N = 253, ONCODAGE: N = 1004; mean age: 78.5±5.5 years; 61.7% of men; 37% metastatic; most frequent localisations: breast (34.9%) and colon-rectum (17.7%); 70.7% of patients screened at risk of frailty with G8). Overall survival was 71.1%. GPS was independently associated with death (among normal G8: GPS 1: Hazard Ratio (HR) = 4.48; 95% Confidence Interval (95% CI) = [2.03; 9.89], GPS 2: 11.64 [4.54; 29.81], among abnormal G8: GPS 1: 2.45 [1.79; 3.34], GPS 2: 3.97 [2.93; 5.37]. The addition of GPS to the clinical model (Harell C: 0.82 [0.80; 0.83]) improved discrimination (Harell C: 0.84 [0.82; 0.85], NRI: 11% [5; 19]). Conclusions: GPS could be used in older patients with cancer to help decision-making and prognosis assessment.

scholarly journals Evaluation of the G8 screening tools for fraility in older patients with cancer

2015 ◽  
Vol 26 ◽  
pp. vii119 ◽  
Author(s):  
Asao Ogawa ◽  
Fumio Nagashima ◽  
Tetsuya Hamaguchi
Keyword(s):  
Older Patients ◽  
Screening Tools ◽  
Patients With Cancer

Considerations and Controversies in the Management of Older Patients with Advanced Cancer

2012 ◽  
pp. 321-328 ◽  
Author(s):  
Supriya Gupta Mohile ◽  
Heidi D. Klepin ◽  
Arati V. Rao
Keyword(s):  
Advanced Cancer ◽  
Older Patients ◽  
Clinical Care ◽  
Treatment Options ◽  
Screening Tools ◽  
Patients With Cancer ◽  
Functional Consequences ◽  
Oncology Practice ◽  
Combined Data

Overview: The incidence of cancer increases with age. Oncologists need to be adept at assessing physiologic and functional capacity in older patients in order to provide safe and efficacious cancer treatment. Assessment of underlying health status is especially important for older patients with advanced cancer, for whom the benefits of treatment may be low and the toxicity of treatment high. The comprehensive geriatric assessment (CGA) is the criterion standard for evaluation of the older patient. The combined data from the CGA can be used to stratify patients into categories to better predict risk for chemotherapy toxicity as well as overall outcomes. The CGA can also be used to identify and follow-up on possible functional consequences from treatment. A variety of screening tools might be useful in the oncology practice setting to identify patients who may benefit from further testing and intervention. In this chapter, we discuss how the principles of geriatrics can help improve the clinical care of older adults with advanced cancer. Specifically, we discuss assessing tolerance for treatment, options for chemotherapy scheduling and dosing for older patients with advanced cancer, and management of under-recognized symptoms in older patients with cancer.

P211 COMPARISON OF PROGNOSTIC VALUE FOR G8 SCREENING TOOLS WITH FTRST IN OLDER PATIENTS OF ESOPHAGEAL CANCER

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Terayama Masayoshi ◽  
Yamada Kazuhiko ◽  
Saito Noriyuki ◽  
Wake Hitomi ◽  
Kataoka Atsuko ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Predictive Value ◽  
Older Patients ◽  
Prognostic Value ◽  
Postoperative Outcome ◽  
The Elderly ◽  
Screening Tools ◽  
Ecog Ps

Abstract Aim We investigated two prognostic value of geriatric screening tools, G8 and Flemish version of the Triage Risk Screening Tool (fTRST), for overall survival and postoperative outcome in older patients undergoing esophagectomy for esophageal cancer (EC). Backgrounds&Method The elderly cancer population is a very heterogeneous group due to differences in comorbidities and functional status. G8 and fTRST are short and easy tools to administer in clinical settings and reported to be useful for identifying patients with geriatric risks. However, the prognostic value of G8 and fTRST has not been compared in EC patients after surgery. Patients aged ≥ 70 years old with EC were retrospectively included who received an operation at National Center for Global Health and Medicine from April 2014 to December 2017. G8 and fTRST were administered to all patients. The impaired were defined as a G8 ≤ 14 and fTRST ≥ 2. We evaluated overall survival (OS) and 30-day postoperative complications classified into Clavien-Dindo (CD) severity grade. Results 63 patients were included. Median age was 76 years (range, 70 to 89 years), and 84% of patients were men. 44 patients (69%) were G8 impaired, 22 patients (34%) were fTRST impaired, 23 patients (36%) were impaired on both screening tools. G8 was an independent predictor of overall survival (hazard ratio 9.9; 95% confidence interval 1.24-79.4, p=0.02), while fTRST was not. The CD≥3 postoperative complications occurred in 33 patients (52%). In univariable logistic regressions, ECOG-PS, G8 and fTRST were associated with CD≥3 complications. G8 alone was not independently predictive for CD≥3 complications, however combined with fTRST, the predictive value of G8 was increased (p=0.001). Conclusions G8 is useful for prognostic value of OS and prior to fTRST in EC. G8 combined with Ftrst has the strongest predictive value for postoperative CD≥3 complications. Further studies are needed to design interventions to improve outcomes for those frail patients.

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