Ryo Ishii1, Takenori Ogawa2, Akira Ohkoshi3, Ayako Nakanome3, Masahiro Takahashi4, Yukio Katori3. 1. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8574, Japan. Electronic address: rishii@orl.med.tohoku.ac.jp. 2. Department of Otolaryngology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. 3. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8574, Japan. 4. Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba, Sendai, Miyagi 980-8575, Japan.
Abstract
OBJECTIVES: To clarify the usefulness of geriatric assessment screening tools for predicting prognosis and complications in older adults with head and neck cancer (HNC). MATERIAL AND METHODS: The geriatric-8 (G8) screening tool was administered to 78 older adults with HNC at their first visit to the hospital before any treatments. The ability of the G8 to predict survival was evaluated by receiver operating characteristic (ROC) curve analysis and determining the cut-off value using Youden's Index. The G8 and other factors related to prognosis (age, performance status (PS), Charlson comorbidity index, number of oral medicines (polypharmacy), the controlling nutritional status (CONUT) score for biological nutrition status, and treatment intent (curative or palliative)) were validated by Cox proportional hazards regression analysis. The survival analysis was validated in a propensity score-weighting cohort to correct for confounding factors. Correlations between these factors and complications were examined using Fishers exact test. RESULTS: The G8 cut-off value for overall survival was 10.5 (area under the curve (AUC) 0.69; 95% confidence interval (CI) 0.56-0.82). In the propensity score-weighted cohort, on Cox proportional hazards regression analysis, the hazard ratio of an abnormal G8 (<11) was 3.70 [1.59-8.61 (p = 0.002)], and the hazard ratio of PS-abnormal (≥2) was 0.85 [0.09-7.60 (p = 0.88)]. Thirty-day mortality and all-complication rates were significantly higher in the G8-abnormal group. Neither major complications nor transfer to other institutions was correlated with an abnormal G8. CONCLUSION: The G8 was a strong prognostic factor and a possible predictor of complications in older adults with HNC.
OBJECTIVES: To clarify the usefulness of geriatric assessment screening tools for predicting prognosis and complications in older adults with head and neck cancer (HNC). MATERIAL AND METHODS: The geriatric-8 (G8) screening tool was administered to 78 older adults with HNC at their first visit to the hospital before any treatments. The ability of the G8 to predict survival was evaluated by receiver operating characteristic (ROC) curve analysis and determining the cut-off value using Youden's Index. The G8 and other factors related to prognosis (age, performance status (PS), Charlson comorbidity index, number of oral medicines (polypharmacy), the controlling nutritional status (CONUT) score for biological nutrition status, and treatment intent (curative or palliative)) were validated by Cox proportional hazards regression analysis. The survival analysis was validated in a propensity score-weighting cohort to correct for confounding factors. Correlations between these factors and complications were examined using Fishers exact test. RESULTS: The G8 cut-off value for overall survival was 10.5 (area under the curve (AUC) 0.69; 95% confidence interval (CI) 0.56-0.82). In the propensity score-weighted cohort, on Cox proportional hazards regression analysis, the hazard ratio of an abnormal G8 (<11) was 3.70 [1.59-8.61 (p = 0.002)], and the hazard ratio of PS-abnormal (≥2) was 0.85 [0.09-7.60 (p = 0.88)]. Thirty-day mortality and all-complication rates were significantly higher in the G8-abnormal group. Neither major complications nor transfer to other institutions was correlated with an abnormal G8. CONCLUSION: The G8 was a strong prognostic factor and a possible predictor of complications in older adults with HNC.
Authors: Ajay T Bakas; Aniel Sewnaik; Jaclyn van Straaten; Robert J Baatenburg de Jong; Francesco U S Mattace-Raso; Harmke A Polinder-Bos Journal: Clin Interv Aging Date: 2021-09-16 Impact factor: 4.458
Authors: Wing Lok Chan; James Chung Hang Chow; Zhi-Yuan Xu; Jishi Li; Wing Tung Gobby Kwong; Wai Tong Ng; Anne W M Lee Journal: Front Oncol Date: 2022-02-01 Impact factor: 6.244