Evelyne Liuu1, Florence Canouï-Poitrine2, Christophe Tournigand3, Marie Laurent4, Philippe Caillet4, Aurelie Le Thuaut5, Helene Vincent6, Stephane Culine7, Etienne Audureau2, Sylvie Bastuji-Garin5, Elena Paillaud4. 1. AP-HP, hôpital Henri-Mondor, Department of Internal Medicine and Geriatrics, Onco-Geriatric Clinic, F-94010 Créteil, France. Electronic address: evelyne.liuu@hmn.aphp.fr. 2. Université Paris Est Créteil (UPEC), LIC EA 4393, F-94010 Créteil, France; AP-HP, hôpital Henri-Mondor, Department of Public Health, F-94010 Créteil, France. 3. AP-HP, hôpital Henri-Mondor, Department of Medical Oncology, F-94010, France. 4. AP-HP, hôpital Henri-Mondor, Department of Internal Medicine and Geriatrics, Onco-Geriatric Clinic, F-94010 Créteil, France; Université Paris Est Créteil (UPEC), LIC EA 4393, F-94010 Créteil, France. 5. Université Paris Est Créteil (UPEC), LIC EA 4393, F-94010 Créteil, France; AP-HP, hôpital Henri-Mondor, Department of Public Health, F-94010 Créteil, France; AP-HP, hôpital Henri-Mondor, Clinical Research Unit (URC-Mondor), F-94010 Créteil, France. 6. AP-HP, hôpital Paul-Brousse, Department of Geriatrics, F-94804 Villejuif, France. 7. AP-HP, hôpital Saint-Louis, Department of Medical Oncology, F-75010 Paris, France.
Abstract
BACKGROUND/ OBJECTIVE: G-8 screening tool showed good screening properties for identifying vulnerable elderly patients with cancer who would benefit from a comprehensive geriatric assessment (CGA). We investigated whether tumour site and metastatic status affected its accuracy. DESIGN: Cross-sectional analysis of a prospective cohort study. SETTING: Geriatric-oncology clinics of two teaching hospitals in the urban area of Paris. PARTICIPANTS: Patients aged 70 or over (n = 518) with breast ( n= 113), colorectal (n = 108), urinary-tract (n = 89), upper gastrointestinal/liver (n = 85), prostate (n = 69), or other cancers (n = 54). MEASUREMENTS: Reference standard for diagnosing vulnerability was the presence of at least one abnormal test among the Activities of Daily Living (ADLs), Instrumental ADL, Mini-Mental State Examination, Mini Nutritional Assessment, Cumulative Illness Rating Scale-Geriatrics, Timed Get-Up-and-Go, and Mini-Geriatric Depression Scale. Sensitivity, specificity and likelihood ratios of G-8 scores ≤ 14 were compared according to tumour site and patient characteristics. RESULTS: Median age was 80; 48.2% had metastases. Prevalence of vulnerability and abnormal G-8 score was 84.2% (95% confidence interval [95% CI], 81-87.3) and 79.5% (95% CI, 76-83). The G-8 was 86.9% sensitive (95% CI, 83.4-89.9) and 59.8% specific (95% CI, 48.3-70.4). G-8 performance varied significantly (all p values < 0.001) across tumour sites (sensitivity, 65.2% in prostate cancer to 95.1% in upper gastrointestinal/liver cancer; and specificity, 23.1% in colorectal cancer to 95.7% in prostate cancer) and metastatic status (sensitivity and specificity, 93.8% and 53.3% in patients with metastases vs. 79.5% and 63.3% in those without, respectively). Differences remained significant after adjustment on age and performance status. CONCLUSION: These G-8 accuracy variations across tumour sites should be considered when using G-8 to identify elderly patients with cancer who could benefit from CGA.
BACKGROUND/ OBJECTIVE:G-8 screening tool showed good screening properties for identifying vulnerable elderly patients with cancer who would benefit from a comprehensive geriatric assessment (CGA). We investigated whether tumour site and metastatic status affected its accuracy. DESIGN: Cross-sectional analysis of a prospective cohort study. SETTING: Geriatric-oncology clinics of two teaching hospitals in the urban area of Paris. PARTICIPANTS: Patients aged 70 or over (n = 518) with breast ( n= 113), colorectal (n = 108), urinary-tract (n = 89), upper gastrointestinal/liver (n = 85), prostate (n = 69), or other cancers (n = 54). MEASUREMENTS: Reference standard for diagnosing vulnerability was the presence of at least one abnormal test among the Activities of Daily Living (ADLs), Instrumental ADL, Mini-Mental State Examination, Mini Nutritional Assessment, Cumulative Illness Rating Scale-Geriatrics, Timed Get-Up-and-Go, and Mini-Geriatric Depression Scale. Sensitivity, specificity and likelihood ratios of G-8 scores ≤ 14 were compared according to tumour site and patient characteristics. RESULTS: Median age was 80; 48.2% had metastases. Prevalence of vulnerability and abnormal G-8 score was 84.2% (95% confidence interval [95% CI], 81-87.3) and 79.5% (95% CI, 76-83). The G-8 was 86.9% sensitive (95% CI, 83.4-89.9) and 59.8% specific (95% CI, 48.3-70.4). G-8 performance varied significantly (all p values < 0.001) across tumour sites (sensitivity, 65.2% in prostate cancer to 95.1% in upper gastrointestinal/liver cancer; and specificity, 23.1% in colorectal cancer to 95.7% in prostate cancer) and metastatic status (sensitivity and specificity, 93.8% and 53.3% in patients with metastases vs. 79.5% and 63.3% in those without, respectively). Differences remained significant after adjustment on age and performance status. CONCLUSION: These G-8 accuracy variations across tumour sites should be considered when using G-8 to identify elderly patients with cancer who could benefit from CGA.
Authors: Fabio Traunero; Francesco Claps; Tommaso Silvestri; Maria Carmen Mir; Luca Ongaro; Michele Rizzo; Andrea Piasentin; Giovanni Liguori; Francesca Vedovo; Antonio Celia; Carlo Trombetta; Nicola Pavan Journal: J Clin Med Date: 2022-06-30 Impact factor: 4.964
Authors: Holly M Holmes; Jude K A Des Bordes; Partow Kebriaei; Sriram Yennu; Richard E Champlin; Sergio Giralt; Supriya G Mohile Journal: J Geriatr Oncol Date: 2014-05-14 Impact factor: 3.599