Evaluation of the G-8 test as a screening for comprehensive geriatric assessment in older patients with cancer
Keywords:
Geriatric Assessment, Neoplasms, Early Detection of Cancer, Sensitivity and Specificity, Frailty, Area Under Curve
Abstract
Objective: To evaluate sensitivity and specificity of the G8 test in screening older adults with cancer who may benefit from a Comprehensive Geriatric Assessment (CGA). Material and methods: This observational retrospective study was carried out in the Geriatrics Service of the Guillermo Almenara Hospital in Lima, Peru. CGA reports were reviewed in the electronic medical records of older adults (> 60 years) with cancer, both outpatients and inpatients, between November 2022 and July 2023. Patients were classified according to the SIOG-1 (International Society of Geriatric Oncology) criteria into two groups: fit and non-fit patients (vulnerable + frail + too sick). Sensitivity, specificity, and positive predictive value, area under the receiver operating characteristic curve (AUC), were estimated for the G8 test. Results: 201 patients entered the study, 91 women (45.3%) and 110 (54.7%) men; their mean age was 76.2 ± 7.4 years. The most frequent neoplasms were colorectal, stomach, prostate, and bile ducts. The prevalence of eligible and unfit patients was 23.4% and 76.6%, respectively. When the G8 test score was ≤11, sensitivity, specificity, positive predictive value, and AUC were 73.4% (95% Confidence Interval: 65.7- 80.2%), 91.5% (79.6%-97.6%), 96.6% (91.7-98.6%), and 89% (84-93%), respectively. Conclusions: The G8 test with a score ≤11 would have high sensitivity and specificity for identifying vulnerable or frail patients with cancer who could benefit from the CGA.
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References
1. Parker SG, McCue P, Phelps K, McCleod A, Arora S, Nockels K, et al. What is Comprehensive Geriatric Assessment (CGA)? An umbrella review. Age Ageing [Internet]. 2018 Jan 1;47(1):149–55. Available from: http://academic.oup.com/ageing/article/47/1/149/4682984
2. Rostoft S, O’Donovan A, Soubeyran P, Alibhai SMH, Hamaker ME. Geriatric Assessment and Management in Cancer. J Clin Oncol [Internet]. 2021 Jul 1;39(19):2058–67. Available from: https://ascopubs.org/doi/10.1200/JCO.21.00089
3. Oscanoa TJ, Vidal X, Beltran BE, Romero-Ortuno R. Comprehensive geriatric assessment and clinical outcomes of frail older adults with diffuse large B-cell lymphoma: a meta-analysis. Oncol Clin Pract [Internet]. 2023 Dec 19;19(6):398–412. Available from: https://journals.viamedica.pl/oncology_in_clinical_practice/article/view/94673
4. Oscanoa TJ, Romero-Ortuno R. The identification of frailty in older people living with diffuse large B-cell lymphoma: a systematic review. Acta Haematol Pol [Internet]. 2023 Nov 7; Available from: https://journals.viamedica.pl/acta_haematologica_polonica/article/view/94456
5. Horgan AM, Leighl NB, Coate L, Liu G, Palepu P, Knox JJ, et al. Impact and Feasibility of a Comprehensive Geriatric Assessment in the Oncology Setting. Am J Clin Oncol [Internet]. 2012 Aug;35(4):322–8. Available from: https://journals.lww.com/00000421-201208000-00004
6. Corre R, Greillier L, Le Caër H, Audigier-Valette C, Baize N, Bérard H, et al. Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study. J Clin Oncol [Internet]. 2016 May 1;34(13):1476–83. Available from: https://ascopubs.org/doi/10.1200/JCO.2015.63.5839
7. Hamaker ME, Wildes TM, Rostoft S. Time to Stop Saying Geriatric Assessment Is Too Time Consuming. J Clin Oncol [Internet]. 2017 Sep 1;35(25):2871–4. Available from: https://ascopubs.org/doi/10.1200/JCO.2017.72.8170
8. González Serrano A, Laurent M, Barnay T, Martínez-Tapia C, Audureau E, Boudou-Rouquette P, et al. A Two-Step Frailty Assessment Strategy in Older Patients With Solid Tumors: A Decision Curve Analysis. J Clin Oncol [Internet]. 2023 Feb 1;41(4):826–34. Available from: https://ascopubs.org/doi/10.1200/JCO.22.01118
9. Garcia M V., Agar MR, Soo W-K, To T, Phillips JL. Screening Tools for Identifying Older Adults With Cancer Who May Benefit From a Geriatric Assessment. JAMA Oncol [Internet]. 2021 Apr 1;7(4):616. Available from: https://jamanetwork.com/journals/jamaoncology/fullarticle/2774872
10. Saliba D, Elliott M, Rubenstein LZ, Solomon DH, Young RT, Kamberg CJ, et al. The Vulnerable Elders Survey: A Tool for Identifying Vulnerable Older People in the Community. J Am Geriatr Soc [Internet]. 2001 Dec;49(12):1691–9. Available from: http://doi.wiley.com/10.1046/j.1532-5415.2001.49281.x
11. Bellera CA, Rainfray M, Mathoulin-Pélissier S, Mertens C, Delva F, Fonck M, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol [Internet]. 2012 Aug;23(8):2166–72. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0923753419381025
12. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition [Internet]. 1999 Feb;15(2):116–22. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0899900798001713
13. Zhao H, Lu X, Zheng S, Wei D, Zhao L, Wang Y, et al. Comparison of two frailty screening tools in older patients with colorectal cancer. BMC Geriatr [Internet]. 2023 May 15;23(1):295. Available from: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-03974-3
14. Droz J-P, Balducci L, Bolla M, Emberton M, Fitzpatrick JM, Joniau S, et al. Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int [Internet]. 2010 Aug;106(4):462–9. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09334.x
15. Droz J-P, Aapro M, Balducci L, Boyle H, Van den Broeck T, Cathcart P, et al. Management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology. Lancet Oncol [Internet]. 2014 Aug;15(9):e404–14. Available from: https://linkinghub.elsevier.com/retrieve/pii/S147020451470018X
16. Ferrat E, Paillaud E, Caillet P, Laurent M, Tournigand C, Lagrange J-L, et al. Performance of Four Frailty Classifications in Older Patients With Cancer: Prospective Elderly Cancer Patients Cohort Study. J Clin Oncol [Internet]. 2017 Mar 1;35(7):766–77. Available from: https://ascopubs.org/doi/10.1200/JCO.2016.69.3143
17. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ [Internet]. 2015 Oct 28;h5527. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.h5527
18. Katz S. Studies of Illness in the Aged. JAMA [Internet]. 1963 Sep 21;185(12):914. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1963.03060120024016
19. Lobo A, Saz P, Marcos G, Día JL, de la Cámara C, Ventura T, et al. [Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population]. Med Clin (Barc) [Internet]. 1999 Jun 5;112(20):767–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10422057
20. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF). Journals Gerontol Ser A Biol Sci Med Sci [Internet]. 2001 Jun 1;56(6):M366–72. Available from: https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/56.6.M366
21. Raynaud-Simon A, Revel-Delhom C, Hébuterne X. Clinical practice guidelines from the French health high authority: Nutritional support strategy in protein-energy malnutrition in the elderly. Clin Nutr [Internet]. 2011 Jun;30(3):312–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0261561410002153
22. García González J V, Díaz Palacios E, Salamea García A, Cabrera González D, Menéndez Caicoya A, Fernández Sánchez A, et al. [An evaluation of the feasibility and validity of a scale of social assessment of the elderly]. Aten primaria [Internet]. 1999 Apr 30;23(7):434–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10363397
23. Bell CC. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. JAMA J Am Med Assoc [Internet]. 1994 Sep 14;272(10):828. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1994.03520100096046
24. Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research: Application of the Cumulative Illness Rating Scale. Psychiatry Res [Internet]. 1992 Mar;41(3):237–48. Available from: https://linkinghub.elsevier.com/retrieve/pii/016517819290005N
25. Droz J, Balducci L, Bolla M, Emberton M, Fitzpatrick JM, Joniau S, et al. Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int [Internet]. 2010 Aug 23;106(4):462–9. Available from: https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09334.x
26. Baitar A, Van Fraeyenhove F, Vandebroek A, De Droogh E, Galdermans D, Mebis J, et al. Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer. J Geriatr Oncol [Internet]. 2013 Jan;4(1):32–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1879406812000768
27. Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H, et al. Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study. Williams BO, editor. PLoS One [Internet]. 2014 Dec 11;9(12):e115060. Available from: https://dx.plos.org/10.1371/journal.pone.0115060
28. Marenco D, Marinello R, Berruti A, Gaspari F, Stasi MF, Rosato R, et al. Multidimensional geriatric assessment in treatment decision in elderly cancer patients: 6-year experience in an outpatient geriatric oncology service. Crit Rev Oncol Hematol [Internet]. 2008 Nov;68(2):157–64. Available from: https://linkinghub.elsevier.com/retrieve/pii/S104084280800142X
2. Rostoft S, O’Donovan A, Soubeyran P, Alibhai SMH, Hamaker ME. Geriatric Assessment and Management in Cancer. J Clin Oncol [Internet]. 2021 Jul 1;39(19):2058–67. Available from: https://ascopubs.org/doi/10.1200/JCO.21.00089
3. Oscanoa TJ, Vidal X, Beltran BE, Romero-Ortuno R. Comprehensive geriatric assessment and clinical outcomes of frail older adults with diffuse large B-cell lymphoma: a meta-analysis. Oncol Clin Pract [Internet]. 2023 Dec 19;19(6):398–412. Available from: https://journals.viamedica.pl/oncology_in_clinical_practice/article/view/94673
4. Oscanoa TJ, Romero-Ortuno R. The identification of frailty in older people living with diffuse large B-cell lymphoma: a systematic review. Acta Haematol Pol [Internet]. 2023 Nov 7; Available from: https://journals.viamedica.pl/acta_haematologica_polonica/article/view/94456
5. Horgan AM, Leighl NB, Coate L, Liu G, Palepu P, Knox JJ, et al. Impact and Feasibility of a Comprehensive Geriatric Assessment in the Oncology Setting. Am J Clin Oncol [Internet]. 2012 Aug;35(4):322–8. Available from: https://journals.lww.com/00000421-201208000-00004
6. Corre R, Greillier L, Le Caër H, Audigier-Valette C, Baize N, Bérard H, et al. Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study. J Clin Oncol [Internet]. 2016 May 1;34(13):1476–83. Available from: https://ascopubs.org/doi/10.1200/JCO.2015.63.5839
7. Hamaker ME, Wildes TM, Rostoft S. Time to Stop Saying Geriatric Assessment Is Too Time Consuming. J Clin Oncol [Internet]. 2017 Sep 1;35(25):2871–4. Available from: https://ascopubs.org/doi/10.1200/JCO.2017.72.8170
8. González Serrano A, Laurent M, Barnay T, Martínez-Tapia C, Audureau E, Boudou-Rouquette P, et al. A Two-Step Frailty Assessment Strategy in Older Patients With Solid Tumors: A Decision Curve Analysis. J Clin Oncol [Internet]. 2023 Feb 1;41(4):826–34. Available from: https://ascopubs.org/doi/10.1200/JCO.22.01118
9. Garcia M V., Agar MR, Soo W-K, To T, Phillips JL. Screening Tools for Identifying Older Adults With Cancer Who May Benefit From a Geriatric Assessment. JAMA Oncol [Internet]. 2021 Apr 1;7(4):616. Available from: https://jamanetwork.com/journals/jamaoncology/fullarticle/2774872
10. Saliba D, Elliott M, Rubenstein LZ, Solomon DH, Young RT, Kamberg CJ, et al. The Vulnerable Elders Survey: A Tool for Identifying Vulnerable Older People in the Community. J Am Geriatr Soc [Internet]. 2001 Dec;49(12):1691–9. Available from: http://doi.wiley.com/10.1046/j.1532-5415.2001.49281.x
11. Bellera CA, Rainfray M, Mathoulin-Pélissier S, Mertens C, Delva F, Fonck M, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol [Internet]. 2012 Aug;23(8):2166–72. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0923753419381025
12. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition [Internet]. 1999 Feb;15(2):116–22. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0899900798001713
13. Zhao H, Lu X, Zheng S, Wei D, Zhao L, Wang Y, et al. Comparison of two frailty screening tools in older patients with colorectal cancer. BMC Geriatr [Internet]. 2023 May 15;23(1):295. Available from: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-03974-3
14. Droz J-P, Balducci L, Bolla M, Emberton M, Fitzpatrick JM, Joniau S, et al. Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int [Internet]. 2010 Aug;106(4):462–9. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09334.x
15. Droz J-P, Aapro M, Balducci L, Boyle H, Van den Broeck T, Cathcart P, et al. Management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology. Lancet Oncol [Internet]. 2014 Aug;15(9):e404–14. Available from: https://linkinghub.elsevier.com/retrieve/pii/S147020451470018X
16. Ferrat E, Paillaud E, Caillet P, Laurent M, Tournigand C, Lagrange J-L, et al. Performance of Four Frailty Classifications in Older Patients With Cancer: Prospective Elderly Cancer Patients Cohort Study. J Clin Oncol [Internet]. 2017 Mar 1;35(7):766–77. Available from: https://ascopubs.org/doi/10.1200/JCO.2016.69.3143
17. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ [Internet]. 2015 Oct 28;h5527. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.h5527
18. Katz S. Studies of Illness in the Aged. JAMA [Internet]. 1963 Sep 21;185(12):914. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1963.03060120024016
19. Lobo A, Saz P, Marcos G, Día JL, de la Cámara C, Ventura T, et al. [Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population]. Med Clin (Barc) [Internet]. 1999 Jun 5;112(20):767–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10422057
20. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF). Journals Gerontol Ser A Biol Sci Med Sci [Internet]. 2001 Jun 1;56(6):M366–72. Available from: https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/56.6.M366
21. Raynaud-Simon A, Revel-Delhom C, Hébuterne X. Clinical practice guidelines from the French health high authority: Nutritional support strategy in protein-energy malnutrition in the elderly. Clin Nutr [Internet]. 2011 Jun;30(3):312–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0261561410002153
22. García González J V, Díaz Palacios E, Salamea García A, Cabrera González D, Menéndez Caicoya A, Fernández Sánchez A, et al. [An evaluation of the feasibility and validity of a scale of social assessment of the elderly]. Aten primaria [Internet]. 1999 Apr 30;23(7):434–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10363397
23. Bell CC. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. JAMA J Am Med Assoc [Internet]. 1994 Sep 14;272(10):828. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1994.03520100096046
24. Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research: Application of the Cumulative Illness Rating Scale. Psychiatry Res [Internet]. 1992 Mar;41(3):237–48. Available from: https://linkinghub.elsevier.com/retrieve/pii/016517819290005N
25. Droz J, Balducci L, Bolla M, Emberton M, Fitzpatrick JM, Joniau S, et al. Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int [Internet]. 2010 Aug 23;106(4):462–9. Available from: https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09334.x
26. Baitar A, Van Fraeyenhove F, Vandebroek A, De Droogh E, Galdermans D, Mebis J, et al. Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer. J Geriatr Oncol [Internet]. 2013 Jan;4(1):32–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1879406812000768
27. Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H, et al. Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study. Williams BO, editor. PLoS One [Internet]. 2014 Dec 11;9(12):e115060. Available from: https://dx.plos.org/10.1371/journal.pone.0115060
28. Marenco D, Marinello R, Berruti A, Gaspari F, Stasi MF, Rosato R, et al. Multidimensional geriatric assessment in treatment decision in elderly cancer patients: 6-year experience in an outpatient geriatric oncology service. Crit Rev Oncol Hematol [Internet]. 2008 Nov;68(2):157–64. Available from: https://linkinghub.elsevier.com/retrieve/pii/S104084280800142X
Published
2024-03-30
How to Cite
1.
Oscanoa TJ, Cieza-Macedo E, Leon-Curiñaupa S, Amado-Tineo J. Evaluation of the G-8 test as a screening for comprehensive geriatric assessment in older patients with cancer. Acta Med Peru [Internet]. 2024Mar.30 [cited 2024Dec.25];41(1). Available from: http://54.39.98.165/index.php/AMP/article/view/2904
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