Clinical significance of the G8 screening tool in elderly patients with oral squamous cell carcinoma
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The present study investigated the clinical significance of the G8 screening tool in elderly oral squamous cell carcinoma (OSCC) patients using a multicenter analysis.
Materials and methods
The medical records of 438 primary OSCC patients aged 75 years and older were retrospectively reviewed. To examine the clinical significance of the G8 screening tool in elderly OSCC patients, self-reliance (SR) rates and prognostic factors were statistically analyzed.
The mean score of the G8 screening tool was 10.9 ± 2.93. The SR cut-off value of the G8 score was 9.5 in a receiver operating characteristic curve analysis. Five-year overall survival rates were 40.1% in patients with a G8 score < 9.5 and 58.4% in those with a G8 score ≥ 9.5 (p < 0.01). Five-year cancer-specific rates were 34.3% in patients with a G8 score < 9.5 and 55.7% in those with a G8 score ≥ 9.5 (p < 0.01). Five-year SR rates were 40.7% in patients with a G8 score < 9.5 and 55.3% in those with a G8 score ≥ 9.5 (p < 0.05). A multivariate analysis identified an advanced age (≥ 80 vs < 80; HR, 1.437; 95%CI, 1.181–1.843; p < 0.01), poorer ECOG-PS (2–4 vs 0–1; HR, 1.560; 95%CI, 1.14–2.106; p < 0.01), and standard treatment (non-standard therapy vs standard therapy; HR, 0.598; 95%CI, 0.405–0.910; p < 0.05) as significant independent prognostic factors for SR. A lower G8 score was associated with poorer SR (≥ 9.5 vs < 9.5; HR, 0.765; 95%CI, 0.575–1.034; p = 0.081).
The clinical significance of the G8 score for elderly OSCC patients was demonstrated and its combination with ECOG-PS may be useful for assessing their prognoses.
KeywordsOral squamous cell carcinoma G8 screening tool Elderly patients Geriatric assessment
Oral squamous cell carcinoma
Quality of life
Eastern Cooperative Oncology Group Performance status
Charlson comorbidity index
National Comprehensive Cancer Network
95% confidence interval
Conception and design of the study: YS and KH
Analysis and interpretation of data: YS and KH
Collection and assembly of data: YS, HT, OK, YN, OM, HM, YS, AM, KT, and UM
Drafting of the article: YS
Critical revision of the article for important intellectual content: YS
Final approval of the article: KH
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study protocol was approved by the Ethics Committee of the Shinshu University School of Medicine (No. 3391).
For this type of study, formal consent is not required.
- 3.Chakiba C, Bellera C, Etchepare F, Mathoulin-Pelissier S, Rainfray M, Soubeyran P (2019) The prognostic value of G8 for functional decline. J Geriatr Oncol. 2019 Jan 9. pii: S1879-4068(18)30265-0. https://doi.org/10.1016/j.jgo.2018.12.004
- 4.Decoster L, Van Puyvelde K, Mohile S, Wedding U, Basso U, Colloca G, Rostoft S, Overcash J, Wildiers H, Steer C, Kimmick G, Kanesvaran R, Luciani A, Terret C, Hurria A, Kenis C, Audisio R, Extermann M (2015) Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations†. Ann Oncol 26(2):288–300CrossRefGoogle Scholar
- 10.Hori M, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H, Japan Cancer Surveillance Research Group (2015) Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project. Jpn J Clin Oncol 45(9):884–891CrossRefGoogle Scholar
- 14.Liuu E, Caillet P, Curé H, Anfasi N, De Decker L, Pamoukdjian F, Canouï-Poitrine F, Soubeyran P, Paillaud E; sous l’égide de la Société francophone d’oncogériatrie (SoFOG) (2016) Comprehensive geriatric assessment (CGA) in elderly with cancer: for whom? Rev Med Interne 37(7):480–488 (article in French)CrossRefGoogle Scholar
- 16.NCCN Guidelines (2019) https://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site Accessed 11 April 2019
- 18.Pamoukdjian F, Canoui-Poitrine F, Longelin-Lombard C, Aparicio T, Ganne N, Wind P, Martinez-Tapia C, Audureau E, Sebbane G, Zelek L, Paillaud E (2017) Diagnostic performance of gait speed, G8 and G8 modified indices to screen for vulnerability in older cancer patients: the prospective PF-EC cohort study. Oncotarget 8(31):50393–50402CrossRefGoogle Scholar
- 19.Pottel L, Lycke M, Boterberg T, Pottel H, Goethals L, Duprez F, Van Den Noortgate N, De Neve W, Rottey S, Geldhof K, Buyse V, Kargar-Samani K, Ghekiere V, Debruyne PR (2014) Serial comprehensive geriatric assessment in elderly head and neck cancer patients undergoing curative radiotherapy identifies evolution of multidimensional health problems and is indicative of quality of life. Eur J Cancer Care (Engl) 23(3):401–412CrossRefGoogle Scholar
- 20.Pottel L, Lycke M, Boterberg T, Pottel H, Goethals L, Duprez F, Rottey S, Lievens Y, Van Den Noortgate N, Geldhof K, Buyse V, Kargar-Samani K, Ghekiere V, Debruyne PR (2015) G-8 indicates overall and quality-adjusted survival in older head and neck cancer patients treated with curative radiochemotherapy. BMC Cancer 15:875. https://doi.org/10.1186/s12885-015-1800-1 CrossRefGoogle Scholar
- 22.Schulkes KJG, Souwer ETD, van Elden LJR, Codrington H, van der Sar-van der Brugge S, Lammers JJ, Portielje JEA, van den Bos F, Hamaker ME (2017) Prognostic value of geriatric 8 and identification of seniors at risk for hospitalized patients screening tools for patients with lung cancer. Clin Lung Cancer 18(6):660–666CrossRefGoogle Scholar
- 23.Sobin LH, Gospodarowicz MK, Wittekind C (eds) (2009) TNM classification of malignant tumours, 7th edn. Wiley-Blackwell, ChichesterGoogle Scholar
- 24.Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H, Albrand G, Servent V, Jean OS, van Praagh I, Kurtz JE, Périn S, Verhaeghe JL, Terret C, Desauw C, Girre V, Mertens C, Mathoulin-Pélissier S, Rainfray M (2014) Screening for vulnerability in older cancer patients: the ONCODAGE prospective multicenter cohort study. PLoS One 9(12):e115060. https://doi.org/10.1371/journal.pone.0115060 CrossRefGoogle Scholar
- 26.Takahashi M, Takahashi M, Komine K, Yamada H, Kasahara Y, Chikamatsu S, Okita A, Ito S, Ouchi K, Okada Y, Imai H, Saijo K, Shirota H, Takahashi S, Mori T, Shimodaira H, Ishioka C (2017) The G8 screening tool enhances prognostic value to ECOG performance status in elderly cancer patients: a retrospective, single institutional study. PLoS One 12(6):e0179694. https://doi.org/10.1371/journal.pone.0179694. eCollection 2017CrossRefGoogle Scholar
- 28.The Japan Geriatrics Society (2019) https://www.jpn-geriat-soc.or.jp/gakujutsu/pdf/public_handbook.pdf Accessed 11 April 2019
- 29.Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen ML, Extermann M, Falandry C, Artz A, Brain E, Colloca G, Flamaing J, Karnakis T, Kenis C, Audisio RA, Mohile S, Repetto L, Van Leeuwen B, Milisen K, Hurria A (2014) International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol 32(24):2595–2603CrossRefGoogle Scholar