Department of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium; Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium.
Department of Psychology, General Hospital Groeninge, Kortrijk, Belgium.
J Geriatr Oncol. 2019 Nov;10(6):931-936. doi: 10.1016/j.jgo.2019.01.001. Epub 2019 Jan 11.
A comprehensive geriatric assessment (CGA) is the key treatment approach to guide decisions in older patients with cancer. In this paper, the added value of an assessment of the patient's hand grip strength to predict survival in patients with an abnormal G8-questionnaire (G8) score is investigated.
Patients were screened by the G8, followed by a CGA in case of an abnormal screening (≤14.0). Hand grip strength was assessed by use of the JAMAR® hydraulic hand dynamometer. Cut-offs were applied according to the Fried frailty criteria. The survival rate was calculated twelve months after the CGA date.
We retrospectively reviewed data of 2071 patients who were treated at the Kortrijk Geriatric Oncology Clinic (General Hospital Groeninge, Belgium) between November 2012 and December 2016. Of those, 944 patients with a mean age of 79.6 years were included in the analyses. 64.2% of patients presented an abnormal hand grip strength score. A log rank test revealed a statistical significant result between patients when accounting for the hand grip strength score (p < .01). When added to a Cox regression model, a significant result was found (p < .01). However, this added only 0.4% to the explained variance of the model.
While a statistically significant result was detected, when adding the hand grip strength score to a regression model for survival, our data indicate that such assessment may clinically be less relevant when included in an already extensive test battery and may therefore provide only limited information in terms of patient survival.
全面老年评估（CGA）是指导老年癌症患者决策的关键治疗方法。本文旨在探讨评估患者手握力对预测 G8 问卷（G8）评分异常患者生存的附加价值。
患者接受 G8 筛查，异常者（≤14.0）进行 CGA。使用 JAMAR®液压测力计评估手握力。根据 Fried 虚弱标准应用截断值。从 CGA 日期起计算 12 个月的生存率。
我们回顾性分析了 2012 年 11 月至 2016 年 12 月在比利时科特赖克老年肿瘤诊所（格罗宁根综合医院）接受治疗的 2071 名患者的数据。其中，944 名平均年龄为 79.6 岁的患者纳入分析。64.2%的患者手握力评分异常。对数秩检验显示，在考虑手握力评分时，患者之间存在统计学显著差异（p<0.01）。当添加到 Cox 回归模型中时，发现了显著结果（p<0.01）。然而，这仅使模型的解释方差增加了 0.4%。
虽然在统计学上检测到显著结果，但当将手握力评分添加到生存的回归模型中时，我们的数据表明，当包含在已经广泛的测试电池中时，这种评估可能在临床上相关性较小，因此在患者生存方面提供的信息可能有限。
