Overall survival in older patients with urologic cancer using G8 and G8m in a Brazilian cancer center.

Abstract

e13760 Background: Aging is a significant risk factor for cancer, with a notable incidence among the elderly. To provide better assistance, international societies recommend the Comprehensive Geriatric Assessment (CGA), a multidisciplinary process aimed at developing a personalized treatment plan. However, CGA requires considerable time and specialized human resources, hindering its use in some healthcare systems. Also, CGA is not recommended for all older cancer patients. Current guidelines recommend the use of high-sensitivity screening tools, such as G8 and G8-modified (G8m), to identify those in CGA need. We aimed to verify the one-year overall survival associated with the G8 and G8m scores in patients aged ≥ 60 years with urological tumors. Methods: For this observational and prospective study, sociodemographic data were collected, G8 and G8m were applied to individuals aged ≥ 60 years with urologic cancer diagnosed within 6 months or prior to a change in therapeutic strategy, from Feb22 to Jan23. The occurrence of outcome (overall survival) was assessed in 1 year after these screening tools. Statistical analyzes were performed, such as mean, median, standard deviation and proportions, as well Kappa Coefficient to compare G8 versus G8m scores. Kaplan-Meier method was used to estimate one-year survival curves and Log-rank Test to evaluate the differences according to baseline scores from G8 (normal >14 or abnormal ≤14) and G8m (normal <6 or abnormal ≥6). Results: 58 participants were included, with a median age of 71 years old, and 93.1% of them were men. The most frequent cancer type was prostate (74.1%), followed by bladder cancer (13.8%). 45 patients (77.6%) were changing treatment strategy, and 13 (22.4%) received a diagnosis within 6 months. Most patients (70.7%) were stage IV. The G8 mean score was 13.5 (±2.6) and G8m, 7.9 (±7.2). A moderate agreement (77.8%) was found between normal G8 and G8m scores (Kappa = 0.551 and p <0.001) (Table). 9 individuals (15.1%) died within 1 year and all of whom had scored abnormally in G8 and G8m. The Kaplan-Meier estimator indicated that abnormal G8 and G8m scores impacted the one-year survival (p = 0.002, for both tools). Conclusions: In older patients with urologic cancer, G8 and G8m showed similar results in identifying patients with frailties who would require a CGA. In addition, this study indicates the predictive value of G8 and G8m for one-year overall survival in this setting. Therefore, our findings support the use of these geriatric screening tools in daily practice of Geriatric Oncology, optimizing treatment planning for older patients. [Table: see text]