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

• Published in: PloS one Vol. 12; no. 6; p. e0179694
• Main Authors: Takahashi, Masahiro, Takahashi, Masanobu, Komine, Keigo, Yamada, Hideharu, Kasahara, Yuki, Chikamatsu, Sonoko, Okita, Akira, Ito, Shukuei, Ouchi, Kota, Okada, Yoshinari, Imai, Hiroo, Saijo, Ken, Shirota, Hidekazu, Takahashi, Shin, Mori, Takahiro, Shimodaira, Hideki, Ishioka, Chikashi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 22.06.2017; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Aging; Cancer; Cancer patients; Cancer research; Cancer therapies; Chemotherapy; Classification; Comorbidity; Confidence intervals; Elderly patients; Family medical history; Female; Gastrointestinal cancer; Gastrointestinal Neoplasms - diagnosis; Gastrointestinal Neoplasms - pathology; Geriatric Assessment - methods; Geriatrics; Group dynamics; Hematology; Humans; Male; Medical prognosis; Medical tests; Medicine and Health Sciences; Missing data; Mortality; Multivariate analysis; Neoplasm Staging; Neoplasms - diagnosis; Neoplasms - pathology; Older people; Oncology; Patients; People and Places; Pricing policies; Prognosis; Retrospective Studies; Risk; Screening; Studies; Survival; Survival Analysis; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0179694

Some 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. Cancer 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. Out 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. This 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.