First validation of the G-8 geriatric screening tool in older patients with glioblastoma

Deluche, Élise; Léobon, Sophie; Lamarche, F.; Tubiana-Mathieu, Nicole

doi:10.1016/j.jgo.2018.07.002

Cited by 21 publications

(14 citation statements)

References 28 publications

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“…Interestingly, frail patients received only 2.8 cycles of temozolomide after chemoradiotherapy due to progressive disease, toxicity, or death. Although KPS is a well-established prognostic factor for glioblastoma patients and we showed an association between KPS and CGA categories, CGA is a useful instrument which adds information to the performance status in the decision making for elderly cancer patients [9,30,31]. In our series, 47% of patients who were deemed frail at CGA had a good KPS between 70 and 100.…”

Section: Discussionmentioning

confidence: 60%

“…Our study, compared to that of Fiorentino and colleagues, was based on a more representative patient population, given the higher sample size, and took into account all the potentially impaired domains in elderly patients, not just comorbidity, allowing for a more precise patient classification. Recently, Deluche et al [30] demonstrated the role of the screening tool G8 in predicting prognosis in elderly patients with newly diagnosed glioblastoma; they reported a median OS of 8.0 months in patients with abnormal G8 score and 42 months in those with a normal G8 score ( p < 0.0001). Although patients with impaired G8 had a HR of 10.27, the difference in overall survival was too wide between the two groups of patients (∆ = 34 months); therefore for a better identification of patients with a poor prognosis, the authors classified the patients into 3 categories (low, intermediate, and high score group), demonstrating a statistically different OS among these groups; however, contrary to expectations, “intermediate” patients reported a higher HR compared to those of the high score group (55.46 versus 8.6, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the HR of “frail” was higher than “vulnerable” patients, as expected. Unlike the work by Deluche et al [30], we also analyzed the role of MGMT, an important prognostic and predictor factor in EGP; our univariate and multivariate analyses included MGMT methylation status.…”

Section: Discussionmentioning

confidence: 99%

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Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients

Lombardi

Bergo

Caccese

et al. 2019

Cancers

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Background: Treatment of elderly glioblastoma patients (EGP) is a challenge in neuro-oncology. The comprehensive geriatric assessment (CGA) is currently used to assess geriatric oncological patients with other types of tumors. We performed a large retrospective study to analyze its predictive role in EGP. Methods: Patients aged ≥65 years with histologically confirmed diagnosis of glioblastoma were enrolled. CGA included the following tests: the Cumulative Illness Rating Scale-Comorbidity and Severity Index, Activities of Daily Living, Instrumental Activities of Daily Living, the Mini Mental State Examination, and the Geriatric Depression Scale. Based on CGA results, each patient was categorized as fit, vulnerable, or frail. Results: We enrolled 113 patients. According to the CGA scores, 35% of patients were categorized as “fit”, 30% as “vulnerable”, and 35% as “frail” patients. Median overall survival was 16.5, 12.1, and 10.3 months in fit, vulnerable, and frail patients (p = 0.1), respectively. On multivariate analysis, the CGA score resulted an independent predictor of survival; indeed, vulnerable and frail patients had a hazard ratio of 1.5 and 2.2, respectively, compared to fit patients (p = 0.04). No association between CGA and progression-free survival (PFS) was demonstrated. Conclusions: The CGA score proved to be a significant predictor of mortality in EGP, and it could be a useful treatment decision tool.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients

Lombardi

Bergo

Caccese

et al. 2019

Cancers

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“…Tools such as the European Organisation for Research and Treatment of Cancer GBM calculator (https://www.eortc.be/tools/ gbmcalculator/) and the Geriatric 8 (G8) scale can help in objective decision making and ensuring that decisions are not based on chronologic age alone. 14 Isocitrate dehydrogenase-wildtype (IDHwt) gliomas constitute the majority of high-grade tumors in adult neurooncology patients. These tumors can grow rapidly in short periods of time, and deferral of therapy beyond the anticipated length of the pandemic carries a high risk of tumor growth, increased neurological morbidity, and in some cases, earlier death.…”

Section: Assess Risk and Benefit Of Therapeutic Interventions In Adulmentioning

confidence: 99%

Urgent considerations for the neuro-oncologic treatment of patients with gliomas during the COVID-19 pandemic

et al. 2020

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Abstract The COVID-19 outbreak is posing unprecedented risks and challenges for all communities and health care systems, worldwide. There are unique considerations for many adult patients with gliomas who are vulnerable to the novel coronavirus due to older age and immunosuppression. As patients with terminal illnesses, they present ethical challenges for centers that may need to ration access to ventilator care due to insufficient critical care capacity. It is urgent for the neuro-oncology community to develop a proactive and coordinated approach to the care of adults with gliomas in order to provide them with the best possible oncologic care while also reducing their risk of viral infection during times of potential health care system failure. In this article, we present an approach developed by an international multidisciplinary group to optimize the care of adults with gliomas during this pandemic. We recommend measures to promote strict physical distancing and minimize exposures for patients, address risk and benefit of all therapeutic interventions, proactively develop end-of-life plans, educate patients and caregivers, and ensure the health of the multidisciplinary neuro-oncology workforce. This pandemic is already changing neuro-oncologic care delivery around the globe. It is important to highlight opportunities to maximize the benefit and minimize the risk of glioma management during this pandemic and potentially, in the future.

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“…Median survival was 4 months in the low score group, 15 months in the intermediate score group, and 42 months in the high score group. The G8 score was identified as a significant independent prognostic factor, showing a potential role of this simple score to guide the therapeutic decision (Deluche et al 2019). Other scores such as the Charlson comorbidity index and the Instrumental Activities of Daily Living questionnaire are also available.…”

Section: Managementmentioning

confidence: 99%

Tumors: Brain

Rhun

Weller

2020

Encyclopedia of Gerontology and Population Aging

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Primary brain tumors are thought to originate from neuroglial progenitor cells of the central nervous system (CNS). The current World Health Organization (WHO) classification for brain tumors was published in 2016 (Louis et al. 2016) and uses morphological characteristics based on presumed origin of the cells, malignancy grades ranging from I to IV based on histological features, and molecular genetic markers. New approaches to brain tumor classification based on genomic methylation profiling (Capper et al. 2018) have also been recently developed which offer new insight and perspectives. Overview The incidence of primary CNS tumors is highly age-dependent. Medulloblastoma and pineal parenchymal tumors are mainly childhood tumors, whereas the most frequent primary brain tumors such as glioblastoma and meningioma are more frequent in adults, and their incidence strongly increases with age (Table 1). Between 2011 and 2015, the overall incidence rate of primary brain tumors was 23.03 per 100,000 in the US population, 5.65 per 100,000 between 0 and 14 years, 41.7 per 100,000 in adults aged of 40 years or more, and 83.75 per 100,000 in adults aged of 85 years or more (Ostrom et al. 2018). Glioblastomas are the most frequent primary malignant brain tumors. The median age at glioblastoma diagnosis is 65 years, and the annual incidence rate per 100,000 of glioblastoma is estimated at 15.13 in the 75-84 years population and 9.07 in the 85+ population (Ostrom et al. 2018). The median age at diagnosis of meningioma is 66 years. Meningioma represents the most frequent primary brain tumor and has an annual incidence rate of 40.8 in the 75-84 years population and 52.5 in the 85+ population (Ostrom et al. 2018). The incidence of CNS metastases should also increase in the future, due to aging of the

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First validation of the G-8 geriatric screening tool in older patients with glioblastoma

Abstract: Here, we highlighted the possibility of using the G8 score, with possibly three cut-offs, in the management of older patients with glioblastoma and determined the prognostic role of this quick and easy screening tool.

Cited by 21 publications

References 28 publications

Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients

Validation of the Comprehensive Geriatric Assessment as a Predictor of Mortality in Elderly Glioblastoma Patients

Urgent considerations for the neuro-oncologic treatment of patients with gliomas during the COVID-19 pandemic

Tumors: Brain

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