Impact of geriatric assessment on the management of older adults with head and neck cancer: A pilot study.
Assess the utility of the G8 screening tool and CGA for older adults with head and neck cancer.



Patients 65years or older with a primary malignancy of the head and neck region were presented at the multidisciplinary team (MDT) meeting. The Geriatric 8 (G8) questionnaire was administered prior. Clinicians, blinded to the G8 result, made a recommendation on appropriate treatment, including potential referral for CGA. Patients considered vulnerable (G8 score≤14) were also to be referred for CGA. Treatment outcomes were recorded.



Over 6months, 35 patients were recruited, median age 74 (range 65-93). Seventeen (49%) patients were assessed as vulnerable by the G8 score, including 7 (20%) whom the MDT referred for CGA. Seven with G8 scores≤14 did not receive a CGA. Thirty (85.7%) underwent curative intent treatment, including 6 of 7 who had CGA. Of 10 vulnerable patients who did not have CGA, 70% received curative-intent treatment. Mean length of post-operative stay was 12.2 vs. 6.5days in patients deemed vulnerable or fit by G8 scores, respectively (p=0.46); completion rate of radical radiotherapy was 75% vs. 100% in each group, respectively (p=0.13). Mean post-operative length of stay in vulnerable patients who underwent a CGA was 6.2days vs. 17.3days in those who were not referred (p=0.79).



The G8 tool identified twice the number of patients as vulnerable compared to the MDT. There was a trend towards longer postoperative stay and lower radiotherapy completion rates in patients deemed vulnerable by G8 scores.
Department of Oncology, Waikato Hospital, Private Bag 3200, Hamilton 3240, New Zealand. Electronic address: Matthew.Neve@waikatodhb.health.nz.
Matthew
M
Neve
Department of Oncology, Waikato Hospital, Private Bag 3200, Hamilton 3240, New Zealand; Waikato Clinical Campus, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.
Michael B
MB
Jameson
Department of Geriatric Medicine, Waikato Hospital, Hamilton, Private Bag 3200, Hamilton 3240, New Zealand.
Siva
S
Govender
Department of Oncology, Waikato Hospital, Private Bag 3200, Hamilton 3240, New Zealand.
Cristian
C
Hartopeanu
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations
Comprehensive geriatric assessment; G8; Head and neck cancer