Abstract 1596P
Background
Parallel to the ever-growing elderly population, cancer incidence increases with age, due to the fact that population ageing and the consequent increase of life expectancy give more time for cellular dysfunctions including senescence to appear, indirectly favoring carcinogenesis. Geriatric assessment has been increasingly recognized as a prognostic tool to detect frailty in elderly cancer patients. In particular, the G8 score is a simple and reproducible instrument to identify elderly patients who should undergo full geriatric evaluation. The aim of this study was to evaluate the impact of frailty assessment by the G8 screening tool on the outcome of cancer patients.
Methods
Patients > 65 years, with a confirmed cancer diagnosis, referred to our cancer center, received a G8 assessment at the time of first access. Patients were classified as frail if G8 score ≤14. The prognostic role of G8 score was assessed by univariable and multivariable analysis including age, type of tumor, stage and treatment. The primary endpoint was overall survival (OS).
Results
This retrospective analysis was performed on patients referred to Maggiore Hospital in Novara, IT, between 01/2017 and 02/2022. Overall, 411 patients were screened by G8; median age was 76 years (range 64-92) and 298 (72.5%) had a G8 score ≤14. Most represented diagnosis included lung, breast, skin, and colon cancer and 52.5% of patients had metastatic disease; 65.0% of them received an active cancer therapy. Median overall survival (OS) was 26 months; 23 months in patients with a G8 score ≤14 vs 30 months in non-frail patients (HR 2.43; 95% CI 1.53- 3.85 p value<0.0001). By multivariable analysis G8 score and male sex were significantly associated with a worse outcome: HR 2.32; CI 95% 1.46-3.68 for G8 ≤14 and HR 2.24; CI 95% 1.59-3.15 for male sex. In patients with metastatic disease, median OS was 13 months in frail patients vs 29 months in non-frail patients (HR 2.09; 95% CI 1.15-3.82 p=0.016).
Conclusions
Our analysis indicates that elderly cancer patients with a G8 score ≤14 have a significantly increased risk of death as compared to elderly fit patients, underlying the strong prognostic role of a simple screening tool such as G8.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Alessia Mennitto.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.