Research Papers: Gerotarget (Focus on Aging):
Diagnostic performance of gait speed, G8 and G8 modified indices to screen for vulnerability in older cancer patients: the prospective PF-EC cohort study
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Frederic Pamoukdjian1,2, Florence Canoui-Poitrine3,4, Coralie Longelin-Lombard1, Thomas Aparicio5, Nathalie Ganne6,7,8, Philippe Wind9, Claudia Martinez-Tapia3,4, Etienne Audureau3,4, Georges Sebbane1,2, Laurent Zelek1,10 and Elena Paillaud4,11
1 Geriatric Department, APHP, Avicenne Hospital, Coordination Unit in Geriatric Oncology, Bobigny, France
2 Université Paris 13, Sorbonne Paris Cité, Laboratoire Educations et Pratiques de Santé, Bobigny, France
3 Public Health Department, APHP, Henri-Mondor Hospital, Créteil, France
4 Université Paris-Est, UPEC, DHU A-TVB, IMRB- EA 7376 CEpiA, Clinical Epidemiology And Ageing Unit, Créteil, France
5 Gastroenterology Department, APHP, Avicenne Hospital, Bobigny, France
6 Hepatology Department, APHP, Jean Verdier Hospital, Bondy, France
7 Université Paris 13, Sorbonne Paris Cité, “Equipe Labellisée Ligue Contre le Cancer”, Bobigny, France
8 Inserm, UMR-1162, "Functional Genomics of Solid Tumors", Paris, France
9 APHP, Avicenne Hospital, Surgery Department, Bobigny, France
10 Department of Medical Oncology, APHP, Avicenne Hospital, Bobigny, France
11 Geriatric Department, APHP, Henri-Mondor Hospital, Geriatric Oncology Unit, Créteil, France
Frederic Pamoukdjian, email:
Keywords: geriatric assessment, cancer, vulnerability, gait speed, G8 index, Gerotarget
Received: December 08, 2016 Accepted: April 03, 2017 Published: April 21, 2017
Background: The diagnostic performance of tools used to screen vulnerability in older cancer patients varies widely. We assessed the diagnostic performance of gait speed (GS) for assessing vulnerability in such patients.
Methods: All consecutive outpatients 65 years and older were referred for geriatric oncology assessment (GA) before a therapeutic decision between November 2013 and April 2016 in a bicentric observational and prospective cohort study. Vulnerability was defined as impaired score on at least one of the 6 domains of the GA. GS and the G8 index and G8 modified index were assessed at the first geriatric oncology visit during the GA. Sensitivity, specificity, positive and negative predictive value and positive and negative likelihood ratio were estimated. The accuracy of the three tools was analysed by the area under the receiver operating characteristic curve (AUC).
Results: Among 269 included patients (mean [SD] age, 81.3 years [5.9]; 55% women, 94.4% solid tumors; 39.4% with metastasis), 252 (93.7%) had impaired GA. With the GS threshold of 1 m/s, sensitivity was 79.4% (95% CI, 73.8-84.2), specificity 64.7% (38.3-85.8), and AUC 82.0 (74.0-90.0). The corresponding values for the G8 index were 90.1% (85.7-93.5), 35.3% (14.2-61.7), and 79.0 (70.0-88.0) and G8 modified index were 89.3% (84.8-92.8), 64.7% (38.3-85.8), and 84.0 (74.0-92.0).
Conclusions: GS < 1 m/s with a single measure could be used as a new screening tool for detecting vulnerability in older cancer outpatients. This first external validation of the G8 modified index was very good.
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