Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2019 Jul;51(3):1249-1256. doi: 10.4143/crt.2018.451. Epub 2019 Jan 2.
The purpose of this study was to prospectively validate the Korean Cancer Study Group Geriatric Score (KG)-7, a novel geriatric screening tool, in older patients with advanced cancer planned to undergo first-line palliative chemotherapy.
Participants answered the KG-7 questionnaire before undergoing geriatric assessment (GA) and first-line palliative chemotherapy. The performance of KG-7 was evaluated by calculating the sensitivity (SE), specificity (SP), positive and negative predictive value (PPV and NPV), balanced accuracy (BA), and area under the curve (AUC).
The baseline GA and KG-7 results were collected from 301 patients. The median age was 75 years (range, 70 to 93 years). Abnormal GA was documented in 222 patients (73.8%). Based on the ≤ 5 cut-off value of KG-7 for abnormal GA, abnormal KG-7 score was shown in 200 patients (66.4%). KG-7 showed SE, SP, PPV, NPV, and BA of 75.7%, 59.7%, 84.4%, 46.0%, and 67.7%, respectively; AUC was 0.745 (95% confidence interval, 0.687 to 0.803). Furthermore, patients with higher KG-7 scores showed significantly longer survival (p=0.006).
KG-7 appears to be adequate in identifying patients with abnormal GA prospectively. Hence, KG-7 can be a useful screening tool for Asian countries with limited resources and high patient volume.
本研究旨在前瞻性验证韩国癌症研究小组老年评分(KG-7),这是一种新的老年筛选工具,用于计划接受一线姑息化疗的老年晚期癌症患者。
参与者在接受老年评估(GA)和一线姑息化疗之前回答了 KG-7 问卷。通过计算敏感性(SE)、特异性(SP)、阳性和阴性预测值(PPV 和 NPV)、平衡准确性(BA)和曲线下面积(AUC)来评估 KG-7 的性能。
从 301 名患者中收集了基线 GA 和 KG-7 结果。中位年龄为 75 岁(范围,70 至 93 岁)。222 名患者(73.8%)存在异常 GA。根据 KG-7 用于异常 GA 的≤5 截断值,200 名患者(66.4%)存在异常 KG-7 评分。KG-7 的 SE、SP、PPV、NPV 和 BA 分别为 75.7%、59.7%、84.4%、46.0%和 67.7%;AUC 为 0.745(95%置信区间,0.687 至 0.803)。此外,KG-7 评分较高的患者的生存时间明显更长(p=0.006)。
KG-7 似乎可以充分识别前瞻性异常 GA 患者。因此,KG-7 可以成为资源有限、患者数量众多的亚洲国家有用的筛选工具。