Prognostic value of G8 for functional decline and 1-year mortality in older patients with cancer: A multicenter prospective study

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Abstract

Purpose Geriatric 8 (G8) is a screening tool to identify frail older patients with cancer. Functional decline (FD) is a determinant in quality of life and survival. We aim to determine the predictive value of G8 for FD in patients with cancer after a new treatment, and its prognostic value for 1-year mortality, severe adverse events, and hospitalizations. Methods Prospective multicenter cohort study of patients ≥ 65 years old receiving oncologic treatment in two hospitals assessed with baseline G8. Cut-off value of G8: ≤14. Functional status was assessed using Instrumental Activities of Daily Living (IADL). Primary objective was FD, defined as a decrease of 1 point on IADL after two months of treatment. Results 226 patients were included, 222 started treatments. After two months, IADL was available for 210; twelve patients (5,4%) died before second evaluation. 66.2% (147) presented an altered G8 score. In those with altered G8, 39.3% (53) had FD and in patients with normal G8, only 13.3% (10) (p < 0.001). At final analysis 222 were available for 1-year mortality and 37.8% (84) had died. After one year of treatment beginning, 48.3% (71) of those with altered G8 had died compared with 17.3% (13) of those with normal G8 (p = 0.001). Conclusion FD has an important prognostic value in older patients with cancer and this data shows a strong association of baseline G8 with FD and mortality; supporting the routine use of this tool in the management of older patients with cancer.

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