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J Clin Oncol. 2014 Jan 1;32(1):19-26. doi: 10.1200/JCO.2013.51.1345. Epub 2013 Nov 25.

Performance of two geriatric screening tools in older patients with cancer.

Author information

1
Cindy Kenis, Koen Milisen, Johan Flamaing, and Hans Wildiers, University Hospitals Leuven; Koen Milisen, Johan Flamaing, and Hans Wildiers, Katholieke Universiteit Leuven; Lore Decoster, Katrien Van Puyvelde, Jacques De Grève, and Godelieve Conings, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels; and Jean-Pierre Lobelle, Consultant in Statistics, Beernem, Belgium.

Abstract

PURPOSE:

To compare the diagnostic characteristics of two geriatric screening tools (G8 and Flemish version of the Triage Risk Screening Tool [fTRST]) to identify patients with a geriatric risk profile and to evaluate their prognostic value for functional decline and overall survival (OS).

PATIENTS AND METHODS:

Patients ≥ 70 years old with a malignant tumor were included if a new cancer event occurred requiring treatment decision. Geriatric screening with G8 and fTRST (cutoff ≥ 1 [fTRST (1)] and ≥ 2 [fTRST (2)] evaluated) was performed in all patients, as well as a geriatric assessment (GA) evaluating social situation, functionality (activities of daily living [ADL] + instrumental activities of daily living [IADL]), cognition, depression, and nutrition. Functionality was re-evaluated 2 to 3 months after cancer treatment decision, and death rate was followed. Functional decline and OS were evaluated in relation to normal versus abnormal score on both screening tools.

RESULTS:

Nine hundred thirty-seven patients were included (October 2009 to July 2011). G8 and fTRST (1) showed high sensitivity (86.5% to 91.3%) and moderate negative predictive value (61.3% to 63.4%) to detect patients with a geriatric risk profile. G8 and fTRST (1) were strongly prognostic for functional decline on ADL and IADL, and G8, fTRST (1), and fTRST (2) were prognostic for OS (all P < .001). G8 had the strongest prognostic value for OS (hazard ratio for G8 normal v abnormal, 0.38; 95% CI, 0.27 to 0.52).

CONCLUSION:

Both geriatric screening tools, G8 and fTRST, are simple and useful instruments in older patients with cancer for identifying patients with a geriatric risk profile and have a strong prognostic value for functional decline and OS.

PMID:
24276775
DOI:
10.1200/JCO.2013.51.1345
[Indexed for MEDLINE]

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