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. 2023 Feb;149(2):851-863.
doi: 10.1007/s00432-022-03934-1. Epub 2022 Feb 25.

The preoperative G8 geriatric screening tool independently predicts survival in older patients with endometrial cancer: results of a retrospective single-institution cohort study

Katharina Anic  1 , Christin Altehoefer  2 , Slavomir Krajnak  2 , Mona Wanda Schmidt  2 , Roxana Schwab  2 , Valerie Catherine Linz  2 , Marcus Schmidt  2 , Christiane Westphalen  3 , Erik Kristoffer Hartmann  4 , Annette Hasenburg  2 , Marco Johannes Battista  2
Affiliations

The preoperative G8 geriatric screening tool independently predicts survival in older patients with endometrial cancer: results of a retrospective single-institution cohort study

Katharina Anic et al. J Cancer Res Clin Oncol. 2023 Feb.

Abstract

Purpose: The aim of this retrospective study was to evaluate the prognostic impact of global health status assessment tools in elderly patients with endometrial cancer (EC) on survival.

Methods: Preoperative frailty status was assessed by the G8 geriatric screening tool (G8 Score), Lee Schonberg prognostic index, Charlson Comorbidity index and American Society of Anesthesiologists Physical Status System in women older than 60 years with EC. Univariable and multivariable Cox-regression analyses, as well as Kaplan-Meier survival analyses were performed to determine the prognostic impact. Statistical analyses were adjusted for cancer entity-specific risk factors such as conventional histopathological tumor characteristics and relevant anamnestic life style parameters.

Results: 153 patients with all stages of EC who were operated at the University Medical Center Mainz between 2008 and 2019 were included. In multivariable analyses, only the G8 Score retained independent significance as a prognostic factor for disease-specific survival (DSS) (HR:4.58; 95% CI [1.35-15.51]) and overall survival (OS) (HR:2.89; 95% CI [1.31-6.39]. 92 patients (61.3%) were classified as G8-non-frail with a significantly increased DSS and OS rate compared to the 58 G8-frail patients (DSS:93.8% vs. 60.8%; p < 0.001 and OS:88.2% vs. 49.7%; p < 0.001; respectively).

Conclusions: This is the first study demonstrates the substantial clinical and prognostic impact of the G8 Score on survival in elderly women with EC. Assessing the frailty status to estimate the individual vulnerability of elderly cancer patients could be useful in preoperative decision-making to individualize treatment plans such as the surgical radicality and to improve pre- and postoperative morbidity.

Keywords: Endometrial carcinomas; Frailty; G8 Score; Global health status; Prognosis.

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Conflict of interest statement

Annette Hasenburg reports honoraria and expenses from AstraZeneca, FBA Frauenärzte BundesAkademie GmbH, KlarigoVerlag, MedConcept, Med public GmbH, Med update GmbH, Medicultus, Pfizer, Promedicis GmbH, Pierre Fabre Pharma GmbH, Softconsult, Roche Pharma AG, Streamedup! GmbH, Tesaro Bio Germany GmbH. I am consultant to PharmaMar, Promedicis GmbH, Pierre Fabre Pharma GmbH, Roche Pharma AG and Tesaro Bio Germany GmbH. I have received funded research from Celgene. Roxana Schwab reports honoraria and expenses from Roche Pharma AG and AstraZeneca GmbH. Marcus Schmidt reports personal fees from AstraZeneca, BioNTech, Eisai, Lilly, MSD, Novartis, Pantarhei Bioscience, Pfizer, Roche, and SeaGen outside the submitted work. Institutional research funding from AstraZeneca, BioNTech, Eisai, Genentech, German Breast Group, Novartis, Palleos, Pantarhei Bioscience, Pierre-Fabre, and Roche. Travel reimbursement from Pfizer and Roche. In addition, M.S. is named inventor on patent EP 2390370 B1 and patent EP 2951317 B1 issued. Marco Battista reports honoraria and expenses from Pharma Mar, Astra Zeneca, Tesaro, GSK, Roche, Clovis Oncology. The other authors state that no conflicts of interests are to declare.

Figures

Fig. 1
Fig. 1
Consort statement
Fig. 2
Fig. 2
Kaplan–Meier plots of global health status assessment tools and age. G8 geriatric screening tool (a), (b), Lee Schonberg prognostic index (c), (d), American Society of Anesthesiologists Physical Status System (e), (f), Charlson Comorbidity Index (g), (h), and mean age (i), (j) for disease-specific survival (a, c, e, g, i) and overall survival (b, d, f, h, j)
Fig. 2
Fig. 2
Kaplan–Meier plots of global health status assessment tools and age. G8 geriatric screening tool (a), (b), Lee Schonberg prognostic index (c), (d), American Society of Anesthesiologists Physical Status System (e), (f), Charlson Comorbidity Index (g), (h), and mean age (i), (j) for disease-specific survival (a, c, e, g, i) and overall survival (b, d, f, h, j)
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