The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: A retrospective, single institutional study

Abstract

BackgroundSome elderly cancer patients, even with good Eastern Cooperative Oncology Group performance status (ECOG-PS), have poor survival outcomes and cannot tolerate standard therapy. Few studies have detailed the associations between the G8 screening tool, ECOG-PS, and overall survival (OS) in such patients.MethodsCancer patients, aged 70 years or older, were assessed for G8 and classified into three groups according to their G8 score: <11 as the low score group, 11–14 as the intermediate score group, and >14 as the high score group. We retrospectively analyzed the association between G8 score and OS in all patients and for each ECOG-PS-categorized group.ResultsOut of 264 enrolled patients, most patients (87%) with solid tumor were categorized as TNM stage IV. ECOG-PS was 0 or 1 in 215 patients and ≥2 in 48; there was missing data for one patient. Among all patients, the low score group with a median OS of 7.7 months survived significantly less than both the high score group with a median OS of 25.6 months [Hazard ratio (HR) 3.48; 95% confidence interval (CI), 1.96–6.63; p < 0.0001] and the intermediate score group with a median of 15.6 months (HR 1.83; 95% CI, 1.28–2.65; p < 0.001). In the multivariate analysis, TNM stage and G8 score were independent prognostic factors for OS. When patients with an ECOG-PS of 0 or 1 were analyzed, patients with a lower G8 score showed significantly shorter OS than patients with a higher score when any two groups were compared.ConclusionThis novel classification of the G8 score contributes to prompt identification of patients with poor prognosis and improved the prognostic value of ECOG-PS. Using G8 with ECOG-PS may be helpful in deciding treatment for elderly patients with advanced cancer.

First validation of the G-8 geriatric screening tool in older patients with glioblastoma

“…In a previous retrospective study, Takahashi et al showed that the G8 screening tool adds prognostic value to ECOG-PS in older patient with cancer, with classification into three groups according to two G8 score cut-off values [20]. Other studies also used two cut-offs to improve identification of at-risk patients [15,22].…”

“…Total scores range from 0 to 17, with a score ≥ 14 defined as normal and a score b 14 defined as abnormal (according to the conventional classification system) [13]. For more efficient identification of patients with a poor prognosis, they were also divided into three groups by G8 score: 14.5-17, high score group; 10.5-14, intermediate score group; and b10.5, low score group [20].…”

“…Next, to define the appropriate cut-off for identification of patients with a poor prognosis, we adjusted the cut-off value from 14 to 7 points in 1-point increments, as described previously [20]. The optimal cut-off was 10.5.…”

Predictive values of two frailty screening tools in older patients with solid cancer: a comparison of SAOP2 and G8

“…Thus, it is plausible that subjects with more advanced cancer, and particularly with gastrointestinal and head/neck tumour are frequently comorbid for malnutrition [ 22 ], due to the intense inflammatory response associated with anorexia and cachexia [ 23 ], which can lead to progressive loss of skeletal muscle mass and worsen impairment of function [ 24 ]. Malnutrition has been associated with reduced ability to tolerate anti-cancer therapy, increased severe dose-limiting toxicities, lesser response rates, worse quality of life, decline in performance status, and shorter survival outcomes [ 25 ].…”

Fit for Surgery – Effects of short-course multimodal individualized prehabilitation in high-risk frail colon cancer patients prior to surgery: A feasibility study

“…Frailty was determined by a least one positive criteria on Fried frailty [22,23] or by a Geriatric-8 (G8) score < 14 [24]. Discharge was managed through standardized discharge criteria.…”