Prospective Validation of the Korean Cancer Study Group Geriatric Score (KG)-7, a Novel Geriatric Screening Tool, in Older Patients with Advanced Cancer Undergoing First-line Palliative Chemotherapy
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose The purpose of this study was to prospectively validate the Korean Cancer Study Group Geriatric Score (KG)-7, a novel geriatric screening tool, in older patients with advanced cancer planned to undergo first-line palliative chemotherapy. Materials and Methods Participants answered the KG-7 questionnaire before undergoing geriatric assessment (GA) and first-line palliative chemotherapy. The performance of KG-7 was evaluated by calculating the sensitivity (SE), specificity (SP), positive and negative predictive value (PPV and NPV), balanced accuracy (BA), and area under the curve (AUC). Results The baseline GA and KG-7 results were collected from 301 patients. The median age was 75 years (range, 70 to 93 years). Abnormal GA was documented in 222 patients (73.8%). Based on the ! 5 cut-off value of KG-7 for abnormal GA, abnormal KG-7 score was shown in 200 patients (66.4%). KG-7 showed SE, SP, PPV, NPV, and BA of 75.7%, 59.7%, 84.4%, 46.0%, and 67.7%, respectively; AUC was 0.745 (95% confidence interval, 0.687 to 0.803). Furthermore, patients with higher KG-7 scores showed significantly longer survival (p= 0.006). Conclusion KG-7 appears to be adequate in identifying patients with abnormal GA prospectively. Hence, KG-7 can be a useful screening tool for Asian countries with limited resources and high patient volume.
Abstract
Purpose The purpose of this study was to prospectively validate the Korean Cancer Study Group Geriatric Score (KG)-7, a novel geriatric screening tool, in older patients with advanced cancer planned to undergo first-line palliative chemotherapy. Materials and Methods Participants answered the KG-7 questionnaire before undergoing geriatric assessment (GA) and first-line palliative chemotherapy. The performance of KG-7 was evaluated by calculating the sensitivity (SE), specificity (SP), positive and negative predictive value (PPV and NPV), balanced accuracy (BA), and area under the curve (AUC). Results The baseline GA and KG-7 results were collected from 301 patients. The median age was 75 years (range, 70 to 93 years). Abnormal GA was documented in 222 patients (73.8%). Based on the ! 5 cut-off value of KG-7 for abnormal GA, abnormal KG-7 score was shown in 200 patients (66.4%). KG-7 showed SE, SP, PPV, NPV, and BA of 75.7%, 59.7%, 84.4%, 46.0%, and 67.7%, respectively; AUC was 0.745 (95% confidence interval, 0.687 to 0.803). Furthermore, patients with higher KG-7 scores showed significantly longer survival (p= 0.006). Conclusion KG-7 appears to be adequate in identifying patients with abnormal GA prospectively. Hence, KG-7 can be a useful screening tool for Asian countries with limited resources and high patient volume.
참고문헌 (29)
- Kim YJ, "Comprehensive geriatric assessment in Korean elderly cancer patients receiving chemotherapy", J Cancer Res Clin Oncol, 137, pp.839~847 (2011)
- Extermann M, "Comprehensive geriatric assessment for older patients with cancer", J Clin Oncol, 25, pp.1824~1831 (2007)
- Kim JW, "The early discontinuation of palliative chemotherapy in older patients with cancer", Support Care Cancer, 22, pp.773~781 (2014)
- Extermann M, "Use of comprehensive geriatric assessment in older cancer patients : recommendations from the task force on CGA of the International Society of Geriatric Oncology(SIOG)", Crit Rev Oncol Hematol, 55, pp.241~252 (2005)
- Extermann M, "Predicting the risk of chemotherapy toxicity in older patients : the Chemotherapy Risk Assessment Scale for High-Age Patients(CRASH)score", Cancer, 118, pp.3377~3386 (2012)
- Hurria A, "Predicting chemotherapy toxicity in older adults with cancer : a prospective multicenter study", J Clin Oncol, 29, pp.3457~3465 (2011)
- Kanesvaran R, "Analysis of prognostic factors of comprehensive geriatric assessment and development of a clinical scoring system in elderly Asian patients with cancer", J Clin Oncol, 29, pp.3620~3627 (2011)
- Soubeyran P, "Predictors of early death risk in older patients treated with first-line chemotherapy for cancer", J Clin Oncol, 30, pp.1829~1834 (2012)
- Hamaker ME, "Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review", Lancet Oncol, 13, pp.e437~e444 (2012)
- Decoster L, "Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients : an update on SIOG recommendationsdagger", Ann Oncol, 26, pp.288~300 (2015)
- Kellen E, "Identifying an accurate pre-screening tool in geriatric oncology", Crit Rev Oncol Hematol, 75, pp.243~248 (2010)
- Kenis C, "Performance of two geriatric screening tools in older patients with cancer", J Clin Oncol, 32, pp.19~26 (2014)
- Baitar A, "Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer", J Geriatr Oncol, 4, pp.32~38 (2013)
- Overcash JA, "The abbreviated comprehensive geriatric assessment(aCGA) : a retrospective analysis", Crit Rev Oncol Hematol, 54, pp.129~136 (2005)
- Saliba D, "The Vulnerable Elders Survey : a tool for identifying vulnerable older people in the community", J Am Geriatr Soc, 49, pp.1691~1699 (2001)
- Meldon SW, "A brief risk-stratification tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department", Acad Emerg Med, 10, pp.224~232 (2003)
- Kim JW, "A novel geriatric screening tool in older patients with cancer: the Korean Cancer Study Group Geriatric Score (KG)-7", PLoS One, 10, pp.e0138304~ (2015)
- Kim JW, "Predicting cumulative incidence of adverse events in older patients with cancer undergoing first-line palliative chemotherapy : Korean Cancer Study Group(KCSG)multicentre prospective study", Br J Cancer, 118, pp.1169~1175 (2018)
- Jung HW, "Multidimensional geriatric prognostic index, based on a geriatric assessment, for long-term survival in older adults in Korea", PLoS One, 11, pp.e0147032~ (2016)
- Charlson ME, "A new method of classifying prognostic comorbidity in longitudinal studies : development and validation", J Chronic Dis, 40, pp.373~383 (1987)
- Mahoney FI, "Functional Evaluation : The Barthel Index", Md State Med J, 14, pp.61~65 (1965)
- Won CW, "The validity and reliability of Korean Instrumental Activities of Daily Living (K-IADL) Scale", J Korean Geriatr Soc, 6, pp.273~280 (2002)
- Podsiadlo D, "The timed"Up & Go" : a test of basic functional mobility for frail elderly persons", J Am Geriatr Soc, 39, pp.142~148 (1991)
- Lee DY, "The prevalence of dementia in older people in an urban population of Korea: the Seoul study", J Am Geriatr Soc, 50, pp.1233~1239 (2002)
- Bae JN, "Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients", J Psychosom Res, 57, pp.297~305 (2004)
- Vellas B, "The Mini Nutritional Assessment(MNA)and its use in grading the nutritional state of elderly patients", Nutrition, 15, pp.116~122 (1999)
- Bellera CA, "Screening older cancer patients : first evaluation of the G-8 geriatric screening tool", Ann Oncol, 23, pp.2166~2172 (2012)
- Petit-Moneger A, "Detection of frailty in elderly cancer patients : Improvement of the G8 screening test", J Geriatr Oncol, 7, pp.99~107 (2016)
- Martinez-Tapia C, "Optimizing the G8 screening tool for older patients with cancer : diagnostic performance and validation of a six-item version", Oncologist, 21, pp.188~195 (2016)