The prognostic value of rapid screening tests (RST) in geriatric assessment of patients with cancer over 70.

Abstract

9554 Background: Comprehensive Geriatric Assessment (CGA) may help to evaluate the functional status of elderly patients, but, because time-consuming, RST have been proposed. However, whether these instruments may predict survival is still unclear. The aim of this study was to correlate overall survival (OS) with the results of 3 rapid tests: G8 (1), VES-13 (2, aCGA (3) in patients over 70. Methods: From April 2009 to April 2012, 530 unelected outpatients over 70, 263 males and 267 females, were evaluated. During the first oncologic visit, they were homogeneously assessed by a trained oncogeriatric team using a dedicated, expressly developed web-based software (www: oncoger.ro.it) including all of the 3 rapid tests. Survival curves were drawn using Kaplan-Meier method and compared with log rank test; multivariate analysis was performed according to Cox regression method. Results: The tests identified frail patients as follows: VES-13 69%, aCGA 50%, G8 68.5%. Frailty was significantly associated with poor OS, with different hazard ratios (HR) for each test. HRs for death of frail vs non-frail pts were for aCGA 1.45 (95%CI 1.09-1.89, p=0.008), for VES-13 1.55 (95%CI 1.12-2.00, p=0.005) and for G8 2.57 (95%CI 1.66-2.93, p<0.0001). In the multivariate analysis including the 8 items of the G8 test, appetite loss (HR 1.44, p=0.002), weight loss (HR 1.28, p=0.003), and personal perception of poor health (HR 1.58, p=0.002) were significantly associated with a higher risk of death. Conclusions: i) Frailty, as identified by RST (VES-13, aCGA, G8), is statistically associated with poor OS; ii) G8 presents the most meaningful HR for OS; iii) appetite loss, weight loss and personal perception of poor health are significantly associated with lower OS.Our data show that RST and in particular G8 represent a useful prognostic tool for the assessment of geriatric patients with cancer.