期刊
JOURNAL OF GERIATRIC ONCOLOGY
卷 3, 期 1, 页码 24-32出版社
ELSEVIER
DOI: 10.1016/j.jgo.2011.11.006
关键词
Head and neck cancer; Elderly; Comprehensive geriatric assessment; Screening instrument; Vulnerable Elders Survey-13; G8
资金
- Belgian Federal Government [NKP_24_018]
Objectives: We evaluated two proposed screening tools, the Vulnerable Elders Survey-13 (VES-13) and the G8, to identify patients who could benefit from a comprehensive geriatric assessment (CGA). Materials and Methods: All consecutive patients aged >= 65 years with primary head and neck cancer were assessed with VES-13, G8 and CGA. Receiver operating characteristics (ROC)-analysis was used to determine diagnostic performance of both screening instruments. Results: Fifty-one patients were recruited, of which 39.2%, 66.7% and 68.6%, were defined vulnerable when evaluated with VES-13, G8 and CGA, respectively. The area under the ROC-curves (AUC +/- SE) of VES-13 (0.889 +/- 0.045) and G8 (0.909 +/- 0.040) did not significantly differ (P=0.7083). A sensitivity and specificity of respectively 57.1% and 100% for VES-13 (cut-off >= 3) and 85.7% and 75.0% for G8 (cut-off <= 14) was obtained. The combined score VES-13+(maximum-G8) (AUC=0.971 +/- 0.019) showed a superior AUC to G8 (P=0.0242) and VES-13 (P=0.0237). The Most optimal cut-off score of 5 for the combined test resulted in a sensitivity of 91.4% and a specificity of 93.8%. Positive and negative predictive values were 100% and 51.6%, 88.2% and 70.6%, and 97.0% and 83.3% for the VES-13, G8 and combined test respectively. Conclusion: Both tools were found to have good diagnostic performance. However, at the proposed cut-off scores, our data suggest the G8 as the most optimal screening tool. Moreover, the combined tool could represent an interesting alternative. (C) 2011 Elsevier Ltd. All rights reserved.
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