Prognostic Value of Geriatric 8 and Identification of Seniors at Risk for Hospitalized Patients Screening Tools for Patients With Lung Cancer.
Because of the time-consuming aspect of geriatric assessments, cancer specialists are seeking shorter screening tools to distinguish fit and frail patients. We analyzed the predictive value of the Geriatric 8 (G8) and Identification of Seniors at Risk for Hospitalized Patients (ISAR-HP) in elderly patients with lung cancer.



From January 2014 to April 2016, the data from patients with lung cancer aged > 70 years at 2 teaching hospitals in the Netherlands were included in a database. The patients were classified as potentially frail if they had a G8 of ≤ 14 or ISAR-HP of ≥ 2.



Of the 142 included patients (median age, 77 years; interquartile range, 73-82 years), 108 (76%) were potentially frail. After correction for possible confounders, the potentially frail patients had a significantly greater risk of 1-year mortality (hazard ratio [HR], 4.08; 95% confidence interval [CI] 1.67-9.99; P = .02). Higher disease stage (HR, 1.72; 95% CI, 1.40-2.12; P < .001) was also a significant predictor of mortality; however, initial treatment (standard or otherwise) and age were not. When using both screening instruments separately, an impaired score on the G8 and higher disease stage were the variables remaining in the regression analyses (HR for impaired G8, 3.01; 95% CI, 1.35-6.72; P < .001). Patients with impaired scores on the ISAR-HP and G8 had more geriatric impairments than did patients with only an impaired G8 score.



G8 screening is useful for the prognostication of elderly patients with lung cancer and could be used in combination with ISAR-HP to increase specificity at the cost of sensitivity. Using the ISAR-HP as the only screening tool would be insufficient.
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, Netherlands. Electronic address: kschulkes@diakhuis.nl.
Karlijn J G
KJG
Schulkes
Department of Internal Medicine, Haga Hospital, The Hague, Netherlands.
Esteban T D
ETD
Souwer
Department of Pulmonology, Diakonessenhuis Utrecht, Utrecht, Netherlands.
Leontine J R
LJR
van Elden
Department of Pulmonology, Haga Hospital, The Hague, Netherlands.
Henk
H
Codrington
Department of Pulmonology, Amphia Hospital, Breda, Netherlands.
Simone
S
van der Sar-van der Brugge
Department of Pulmonology, University Medical Center Utrecht, Utrecht, Netherlands.
Jan-Willem J
JJ
Lammers
Department of Internal Medicine, Haga Hospital, The Hague, Netherlands.
Johanneke E A
JEA
Portielje
Department of Internal Medicine, Haga Hospital, The Hague, Netherlands.
Frederiek
F
van den Bos
Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, Netherlands.
Marije E
ME
Hamaker
D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009367:Neoplasm Staging; D009426:Netherlands; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012306:Risk; D012680:Sensitivity and Specificity
Frail; NSCLC; Prognostication; Pulmonary malignancies; Toxicity