A Multi-Center Comparative Analysis of the G8-Score and Charlson Comorbidity Index as General Health Assessment Tools in Older Patients With Prostate Cancer

IF 2.4 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI:10.1016/j.clgc.2025.102454

Brecht Chys , Philip R. Debruyne , Lore Decoster , Cindy Kenis , Hans Wildiers , Diederik Ponette , Steven Joniau

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Abstract

Introduction

Frail and older patients who develop prostate cancer (PCa), are at risk of overtreatment. Multiple general health assessment (GHA) tools have been validated in oncology. we aim to validate and compare the performance of the G8 screening tool, age and Charlson Comorbidity Index (CCI) as a predictor of overall survival (OS) in men older than 70 years with a newly diagnosed prostate cancer. Is it possible to identify a CCI cut-off indicative for frailty?

Patients and methods

Between 2009 and 2015, a national multicenter initiative on geriatric screening and GHA’s took place in Belgium. Baseline characteristics were collected on the date of inclusion on which a specialist nurse completed multiple GHA questionnaires for each patient. We performed a sub analysis on the prostate cancer (n = 182) cohort, ≥ 70 years old. GHA’s were compared through multivariate-, Kaplan-Meier- and sensitivity analysis. If indicated, Case-control matching was applied to reduce variate heterogeneity. Ten-year OS is the primary endpoint.

Results

Men with a G8-score of ≤14 points had a significantly worse OS both in the unmatched: 86.8 months (95% CI: 70.5-103.1) vs. 137.9 months (95% CI: 129.4-146.4) (P < .001) and matched population: 99.3 months (95% CI 81.9-116.73) vs. 136.0 months (95% CI: 121.8-150.2) (P < .05). Defining frailty as the presence of comorbidities (CCI ≥ 1 point) shows inferior (HR:1.3, 95% CI: 0.8-2.1—AUC: 0.583) accuracy compared to the G8-score (HR 2.9, 95% CI 1.8-4.5—AUC: 0.715). If the frailty threshold of the CCI is raised to ≥ 2 points, accuracy is matched (HR 4.9, 95% CI 2.8-8.4—AUC 0.735).

Conclusion

This multicenter analysis validates the predictive value of the G8-score and CCI on OS in newly diagnosed PCa in the older patient. Both GHA’s appear more accurate than age. A CCI ≥ 2 points approximates the sensitivity of G8 defined frailty. External validation of these findings is needed.

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g8评分与Charlson合并症指数作为老年前列腺癌患者一般健康评估工具的多中心比较分析

简介：体弱和老年前列腺癌（PCa）患者有过度治疗的风险。多种一般健康评估（GHA）工具已在肿瘤学中得到验证。我们的目的是验证和比较G8筛查工具、年龄和Charlson合并症指数（CCI）作为70岁以上新诊断前列腺癌男性总生存期（OS）的预测指标的性能。是否有可能确定虚弱的CCI截止指标？患者和方法：2009年至2015年间，比利时开展了一项关于老年筛查和GHA的国家多中心倡议。在纳入之日收集基线特征，专科护士为每位患者完成多份GHA问卷。我们对年龄≥70岁的前列腺癌患者（n = 182）进行了亚组分析。通过多变量分析、Kaplan-Meier分析和敏感性分析比较GHA。如果有提示，则采用病例-对照匹配来减少变量异质性。10年的生存期是主要终点。结果：g8评分≤14分的男性在未匹配人群中(86.8个月（95% CI: 70.5-103.1） vs. 137.9个月（95% CI: 129.4-146.4）（P < 0.001）和匹配人群中(99.3个月（95% CI: 81.9-116.73） vs. 136.0个月（95% CI: 121.8-150.2）（P < 0.05）的OS均明显较差。将虚弱定义为存在合并症（CCI≥1点）的准确性（HR:1.3, 95% CI: 0.8-2.1-AUC: 0.583）低于g8评分（HR 2.9, 95% CI 1.8-4.5-AUC: 0.715）。如果CCI的脆弱阈值提高到≥2点，则准确性匹配（HR 4.9, 95% CI 2.8-8.4-AUC 0.735）。结论：本多中心分析验证了g8评分和CCI对老年新诊断PCa患者OS的预测价值。两种GHA似乎都比年龄更准确。CCI≥2点近似于G8定义的脆弱性敏感性。需要对这些发现进行外部验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.