Stéphanie Dubruille1, Yves Libert2, Myriam Roos3, Sandrine Vandenbossche2, Aurélie Collard3, Nathalie Meuleman4, Marie Maerevoet4, Anne-Marie Etienne5, Christine Reynaert6, Darius Razavi2, Dominique Bron4. 1. Clinic of Psycho-Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Université Catholique de Louvain, Service de Médecine Psychosomatique, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium. 2. Clinic of Psycho-Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 3. Onco-geriatry Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 4. Department of Hematology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. 5. Université de Liège, Faculté des Sciences Psychologiques et de l'Education, Liège, Belgium. 6. Université Catholique de Louvain, Service de Médecine Psychosomatique, Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium.
Abstract
BACKGROUND: Little is known about the reliability of G8 screening tool and the prognostic value of clinical parameters within the Comprehensive Geriatric Assessment (CGA) in clinically fit older patients with hematological malignancies. MATERIALS AND METHODS: This study was performed to assess the reliability of G8 as a screening tool and to determine the predictive value of CGA items in terms of 1-year overall survival (OS). G8 and CGA were proposed to 107 consecutive patients (65-89 years) with hematological malignancies assessed by their physicians as clinically fit, meaning not exhibiting geriatric syndromes and/or irreversible comorbidities significantly impairing their daily function, and thus able to receive chemotherapy. RESULTS: Out of 107 patients, 90 patients were evaluable and completed both scales; 72% and 80% were defined as "vulnerable" when evaluated with G8 (≤ 14.5) or CGA (≥ 2 impairments) respectively. The area under ROC-curve of G8 compared to CGA was 0.749±0.051. Neither G8 nor CGA total scores were predictive of 1-year OS. However, age (HR=1.105, 95% CI: 1.016-1.202; p=0.019), diagnosis (HR=5.208, 95% CI: 1.895-14.310; p=0.001) and cognitive status (HR=3.260, 95% CI: 1.043-10.194; p=0.042) were predictive of OS. CONCLUSIONS: We conclude that in our selected hematological patients: 1) the G8 score does not help selecting patients for CGA, 2) the G8 and CGA total scores do not predict OS, and 3) in addition to the age and disease itself, cognitive impairment appears to be a powerful prognostic factor.
BACKGROUND: Little is known about the reliability of G8 screening tool and the prognostic value of clinical parameters within the Comprehensive Geriatric Assessment (CGA) in clinically fit older patients with hematological malignancies. MATERIALS AND METHODS: This study was performed to assess the reliability of G8 as a screening tool and to determine the predictive value of CGA items in terms of 1-year overall survival (OS). G8 and CGA were proposed to 107 consecutive patients (65-89 years) with hematological malignancies assessed by their physicians as clinically fit, meaning not exhibiting geriatric syndromes and/or irreversible comorbidities significantly impairing their daily function, and thus able to receive chemotherapy. RESULTS: Out of 107 patients, 90 patients were evaluable and completed both scales; 72% and 80% were defined as "vulnerable" when evaluated with G8 (≤ 14.5) or CGA (≥ 2 impairments) respectively. The area under ROC-curve of G8 compared to CGA was 0.749±0.051. Neither G8 nor CGA total scores were predictive of 1-year OS. However, age (HR=1.105, 95% CI: 1.016-1.202; p=0.019), diagnosis (HR=5.208, 95% CI: 1.895-14.310; p=0.001) and cognitive status (HR=3.260, 95% CI: 1.043-10.194; p=0.042) were predictive of OS. CONCLUSIONS: We conclude that in our selected hematological patients: 1) the G8 score does not help selecting patients for CGA, 2) the G8 and CGA total scores do not predict OS, and 3) in addition to the age and disease itself, cognitive impairment appears to be a powerful prognostic factor.
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