The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: A retrospective, single institutional study

<div><p>Background</p><p>Some elderly cancer patients, even with good Eastern Cooperative Oncology Group performance status (ECOG-PS), have poor survival outcomes and cannot tolerate standard therapy. Few studies have detailed the associations between the G8 screening tool, ECOG-PS, and overall survival (OS) in such patients.</p><p>Methods</p><p>Cancer patients, aged 70 years or older, were assessed for G8 and classified into three groups according to their G8 score: <11 as the low score group, 11–14 as the intermediate score group, and >14 as the high score group. We retrospectively analyzed the association between G8 score and OS in all patients and for each ECOG-PS-categorized group.</p><p>Results</p><p>Out of 264 enrolled patients, most patients (87%) with solid tumor were categorized as TNM stage IV. ECOG-PS was 0 or 1 in 215 patients and ≥2 in 48; there was missing data for one patient. Among all patients, the low score group with a median OS of 7.7 months survived significantly less than both the high score group with a median OS of 25.6 months [Hazard ratio (HR) 3.48; 95% confidence interval (CI), 1.96–6.63; p < 0.0001] and the intermediate score group with a median of 15.6 months (HR 1.83; 95% CI, 1.28–2.65; p < 0.001). In the multivariate analysis, TNM stage and G8 score were independent prognostic factors for OS. When patients with an ECOG-PS of 0 or 1 were analyzed, patients with a lower G8 score showed significantly shorter OS than patients with a higher score when any two groups were compared.</p><p>Conclusion</p><p>This novel classification of the G8 score contributes to prompt identification of patients with poor prognosis and improved the prognostic value of ECOG-PS. Using G8 with ECOG-PS may be helpful in deciding treatment for elderly patients with advanced cancer.</p></div

Association between G8 scores and patient characteristics.

<p>Association between G8 scores and patient characteristics.</p

Patient characteristics.

<p>Patient characteristics.</p

Overall survival according to the G8 score in elderly cancer patients categorized as an ECOG-PS of 0 or 1.

<p>Kaplan–Meier analyses for overall survival in patients with high G8 scores (>14), intermediate G8 scores (11–14), or low G8 scores (<11). NR, not reached. ECOG-PS, Eastern Cooperative Oncology Group performance status.</p

Univariate and multivariate analyses for overall survival.

<p>Univariate and multivariate analyses for overall survival.</p

G8 scores.

<p>G8 scores.</p

Overall survival according to the G8 score in elderly cancer patients.

<p>(a) Kaplan–Meier analyses for overall survival in patients with a normal G8 score (>14) or an abnormal G8 score (≤14). (b) Kaplan–Meier analyses for overall survival in patients with high G8 scores (>14), intermediate G8 scores (11–14), or low G8 scores (<11). NR, not reached.</p