The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: A retrospective, single institutional study.
The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: A retrospective, single institutional study.
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DOI：
10.1371/journal.pone.0179694
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Ishioka C
中科院分区：
文献类型：
--
作者：
Takahashi M;Takahashi M;Komine K;Yamada H;Kasahara Y;Chikamatsu S;Okita A;Ito S;Ouchi K;Okada Y;Imai H;Saijo K;Shirota H;Takahashi S;Mori T;Shimodaira H;Ishioka C
一些老年癌症患者，即使具有良好的东部肿瘤协作组体能状态（ECOG-PS），也具有较差的生存结局，并且不能耐受标准治疗。很少有研究详细说明G8筛查工具、ECOG-PS和此类患者的总生存期（OS）之间的相关性。对70岁或以上的癌症患者进行G8评估，并根据他们的G8评分分为三组：<11为低评分组，11-14为中等评分组，>14为高评分组。我们回顾性分析了所有患者和每个ECOG-PS分类组的G8评分与OS之间的关系。在264例入组患者中，大多数实体瘤患者（87%）被归类为TNM IV期。215例患者的ECOG-PS为0或1，48例患者≥2; 1例患者的数据缺失。在所有患者中，中位OS为7.7个月的低评分组的生存期显著低于中位OS为25.6个月的高评分组[风险比（HR）3.48; 95%置信区间（CI），1.96-6.63; p < 0.0001]和中位OS为15.6个月的中位评分组（HR 1.83; 95% CI，1.28-2.65; p < 0.001）。在多因素分析中，TNM分期和G8评分是OS的独立预后因素。当分析ECOG PS为0或1的患者时，G8评分较低的患者的OS显著短于评分较高的患者。这种新的G8评分分类有助于及时识别预后不良的患者，并提高了ECOG-PS的预后价值。采用G8和ECOG-PS可能有助于老年晚期癌症患者的治疗决策。
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. 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. 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. 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.