Doi Ayako, Mizukami Takuro, Takeda Hiroyuki, Umemoto Kumiko, Arai Hiroyuki, Horie Yoshiki, Izawa Naoki, Ogura Takashi, Sunakawa Yu
St. Marianna University School of Medicine, Department of Clinical Oncology, Kawasaki, Japan.
Nippon Telegraph and Telephone Corporation (NTT) Medical Center Tokyo, Department of Medical Oncology, Tokyo, Japan.
Front Oncol. 2023 May 31;13:1110236. doi: 10.3389/fonc.2023.1110236. eCollection 2023.
Geriatric 8 (G8) and instrumental activities of daily living (IADL) are recommended to predict overall survival (OS) or risk of serious adverse events (SAEs) in older cancer patients. However, the clinical utility is relatively unknown in older patients suffering malnutrition with gastrointestinal (GI) cancer, including gastric cancer (GC) and pancreatic cancer (PC).
We retrospectively included patients aged ≥65 years with GC, PC, and colorectal cancer (CRC) who received a G8 questionnaire at first visit from April 2018 to March 2020. The associations between G8/IADL and safety or OS were assessed in patients with advanced/unresectable tumors.
Of 207 patients (median age: 75 years), the median G8 score was 10.5 and normal G8 score rate was 6.8%. Both the median G8 score and normal G8 (>14) score rate numerically increased in the order of GC < PC < CRC. There was no clear association between the G8 standard cutoff value of 14 and SAEs or OS. However, OS was significantly longer in patients with G8 >11 than in those with G8 ≤11 (19.3 vs. 10.5 months, = 0.0017). Furthermore, OS was significantly better in patients with normal IADL than in those with abnormal IADL (17.6 vs. 11.4 months, = 0.049).
The G8 cutoff value of 14 would not be clinically useful in patients with GI cancer for predicting OS or SAEs; however, the cutoff value of 11 and IADL may be useful to predict OS for older patients with GI cancers including GC and PC.
推荐使用老年综合评估8项指标（G8）和工具性日常生活活动能力（IADL）来预测老年癌症患者的总生存期（OS）或严重不良事件（SAE）风险。然而，在患有营养不良的老年胃肠道（GI）癌症患者，包括胃癌（GC）和胰腺癌（PC）中，其临床实用性相对未知。
我们回顾性纳入了2018年4月至2020年3月首次就诊时接受G8问卷调查的年龄≥65岁的GC、PC和结直肠癌（CRC）患者。在晚期/不可切除肿瘤患者中评估G8/IADL与安全性或OS之间的关联。
在207例患者（中位年龄：75岁）中，G8评分中位数为10.5，G8评分正常率为6.8%。G8评分中位数和G8评分正常（>14）率按GC < PC < CRC的顺序在数值上增加。G8标准临界值14与SAEs或OS之间没有明确的关联。然而，G8>11的患者的OS明显长于G8≤11的患者（19.3个月对10.5个月，P = 0.0017）。此外，IADL正常的患者的OS明显优于IADL异常的患者（17.6个月对11.4个月，P = 0.049）。
G8临界值14在预测GI癌症患者的OS或SAEs方面在临床上可能无用；然而，临界值11和IADL可能有助于预测包括GC和PC在内的老年GI癌症患者的OS。
