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. 2017 Jun 22;12(6):e0179694.
doi: 10.1371/journal.pone.0179694. eCollection 2017.

The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: A retrospective, single institutional study

Masahiro Takahashi  1   2 , Masanobu Takahashi  1   2 , Keigo Komine  1   2 , Hideharu Yamada  1   2 , Yuki Kasahara  1   2 , Sonoko Chikamatsu  1   2 , Akira Okita  1   2 , Shukuei Ito  1   2 , Kota Ouchi  1   2 , Yoshinari Okada  1   2 , Hiroo Imai  1   2 , Ken Saijo  1   2 , Hidekazu Shirota  1 , Shin Takahashi  1   2 , Takahiro Mori  1 , Hideki Shimodaira  1   2 , Chikashi Ishioka  1   2
Affiliations

The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: A retrospective, single institutional study

Masahiro Takahashi et al. PLoS One. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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Conflict of interest statement

Competing Interests: Masanobu Takahashi reports receiving research funding from Ono Pharmaceutical Company. K.S. reports receiving research funding from Taiho Pharma. Hideki S. reports receiving research funding from Taiho Pharma. C. I. reports receiving lecture fees from Taiho, Chugai, Takeda, Byer, Pfeizer, Mochida, Asahikasei, Bristol-Myers Squibb, Daiichi-Sankyo, Merck Serono, and Novartis, and research funding from Chugai, Taiho, Bristol-Myers Squibb, Daiichi-Sankyo, Merck Serono, Yakult, Ono, and Novartis. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Overall survival according to the G8 score in elderly cancer patients.
(a) Kaplan–Meier analyses for overall survival in patients with a normal G8 score (>14) or an abnormal G8 score (≤14). (b) Kaplan–Meier analyses for overall survival in patients with high G8 scores (>14), intermediate G8 scores (11–14), or low G8 scores (<11). NR, not reached.
Fig 2
Fig 2. Overall survival according to the G8 score in elderly cancer patients categorized as an ECOG-PS of 0 or 1.
Kaplan–Meier analyses for overall survival in patients with high G8 scores (>14), intermediate G8 scores (11–14), or low G8 scores (<11). NR, not reached. ECOG-PS, Eastern Cooperative Oncology Group performance status.
See this image and copyright information in PMC

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