TY - JOUR
T1 - Predictive Value of Geriatric Oncology Screening and Geriatric Assessment in Older Patients with Solid Cancers
T2 - Protocol for a Danish prospective cohort study (PROGNOSIS-G8)
AU - Ditzel, Helena Møgelbjerg
AU - Giger, Ann Kristine Weber
AU - Lund, Cecilia Margareta
AU - Ditzel, Henrik Jørn
AU - Mohammadnejad, Afsaneh
AU - Pfeiffer, Per
AU - Ryg, Jesper
AU - Jørgensen, Trine Lembrecht
AU - Ewertz, Marianne
N1 - Funding Information:
This study is supported by the Danish Cancer Society (grant # R247-A14382 ), Academy of Geriatric Cancer Research, Odense University Hospital (grant # A4352 ), the University of Southern Denmark , the Research Committee for the Department of Oncology at Odense Univeristy Hospital , and Agnes and Poul Friis Fond (grant # 81008-005 ).
Publisher Copyright:
© 2021 The Authors
PY - 2021/11
Y1 - 2021/11
N2 - Introduction: Older patients with cancer constitute a heterogeneous group with varying degrees of frailty; therefore, geriatric assessment with initial geriatric oncology screening is recommended. The Geriatric 8 (G8) and the modified Geriatric 8 (mG8) are promising screening tools with high accuracy and an association with survival. However, evidence is sparse regarding patient-centered outcomes. This protocol describes a study, which aims to address the predictive and prognostic value of the G8 and mG8, with quality of life (QoL) as the primary outcome. Materials and methods: In this single-center prospective cohort study, patients, age ≥70 years with solid malignancies, will be screened with the G8 and mG8 prior to receiving 1st line antineoplastic treatment. Patients will contribute medical record data including; cancer type, Charlson comorbidity index score, performance status, and treatment intent, type, and dosage, at baseline. Patients will complete QoL questionnaires (EORTC QLQ-C30 and ELD-14) at baseline, 3, 6, 9, and 12-months follow-up. Two functional measurements (the 30-s chair stand test and the handgrip strength test) will be conducted at baseline to assess the added predictive and prognostic value. At 12 months follow-up, initially administered treatment and treatment adherence will be recorded and assessed with generalized linear models, while overall survival and cancer-specific survival will be assessed using survival analysis models with time-varying covariates. The relationship between frailty (G8 ≤ 14, mG8 ≥ 6) and QoL within 12 months will be examined using mixed regression models. Discussion: Geriatric oncology screening may identify a subgroup of older patients with frailty, at risk of experiencing diminishing QoL and poor treatment adherence. With the proposed screening program, patients who require treatment modification and additional support to maintain their QoL may be identified. It is our hope, that these insights may facilitate the formation of national guidelines for the treatment of older patients with cancer. Registration: NCT04644874
AB - Introduction: Older patients with cancer constitute a heterogeneous group with varying degrees of frailty; therefore, geriatric assessment with initial geriatric oncology screening is recommended. The Geriatric 8 (G8) and the modified Geriatric 8 (mG8) are promising screening tools with high accuracy and an association with survival. However, evidence is sparse regarding patient-centered outcomes. This protocol describes a study, which aims to address the predictive and prognostic value of the G8 and mG8, with quality of life (QoL) as the primary outcome. Materials and methods: In this single-center prospective cohort study, patients, age ≥70 years with solid malignancies, will be screened with the G8 and mG8 prior to receiving 1st line antineoplastic treatment. Patients will contribute medical record data including; cancer type, Charlson comorbidity index score, performance status, and treatment intent, type, and dosage, at baseline. Patients will complete QoL questionnaires (EORTC QLQ-C30 and ELD-14) at baseline, 3, 6, 9, and 12-months follow-up. Two functional measurements (the 30-s chair stand test and the handgrip strength test) will be conducted at baseline to assess the added predictive and prognostic value. At 12 months follow-up, initially administered treatment and treatment adherence will be recorded and assessed with generalized linear models, while overall survival and cancer-specific survival will be assessed using survival analysis models with time-varying covariates. The relationship between frailty (G8 ≤ 14, mG8 ≥ 6) and QoL within 12 months will be examined using mixed regression models. Discussion: Geriatric oncology screening may identify a subgroup of older patients with frailty, at risk of experiencing diminishing QoL and poor treatment adherence. With the proposed screening program, patients who require treatment modification and additional support to maintain their QoL may be identified. It is our hope, that these insights may facilitate the formation of national guidelines for the treatment of older patients with cancer. Registration: NCT04644874
KW - Chair stand test
KW - Comprehensive geriatric assessment
KW - Frailty
KW - Geriatric 8
KW - Geriatric oncology
KW - Handgrip strength
KW - Modified geriatric 8
KW - Older adults
KW - Quality of life
KW - Screening
U2 - 10.1016/j.jgo.2021.06.004
DO - 10.1016/j.jgo.2021.06.004
M3 - Journal article
C2 - 34176752
AN - SCOPUS:85108709730
SN - 1879-4068
VL - 12
SP - 1270
EP - 1276
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 8
ER -