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246 Survival of elderly patients with endometrial cancer – predicted by preoperative G-8 geriatric screening tool
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  1. K Anic1,
  2. C Altehoefer1,
  3. MW Schmidt1,
  4. S Krajnak1,
  5. R Schwab1,
  6. V Linz1,
  7. C Westphalen2,
  8. EK Hartmann3,
  9. M Schmidt1,
  10. A Hasenburg1 and
  11. M Battista1
  1. 1University Medical Centre of the Johannes Gutenberg University Mainz, Department of Gynaecology and Obstetrics, Mainz, GERMANY
  2. 2University Medical Centre of the Johannes Gutenberg University Mainz, Department of Geriatric Medicine, Mainz, GERMANY
  3. 3University Medical Centre of the Johannes Gutenberg University Mainz, Department of Anesthesiology, Mainz, GERMANY

Abstract

Introduction/Background*We evaluated the prognostic impact of various global health assessment tools in accordance to conventional prognostic factors in patients with endometrial cancer (EC) older than 60 years.

Methodology G-8 geriatric screening tool (G-8 geriatric score), Lee Schonberg prognostic index (Lee-Index), Charlson Comorbidity Index (CCI) and American Society of Anesthesiologists (ASA-PS) – Physical Status System were retrospectively determined in a consecutive cohort of elderly patients with EC. Univariate and multivariate Cox regression analyses and Kaplan-Meier method were performed to determine the impact of the global health assessment tools on progression free survival (PFS) and overall survival (OS).

Result(s)*153 patients entered the study. In multivariate analysis adjusted for common clinical-pathological risk factors (e.g. histological type and stadium, histological grading, FIGO-stadium, tumor stadium and postoperative tumor burden) and different global health assessment tools (G-8 geriatric score, Lee-Index, CCI and ASA-PS) only the G-8 geriatric score retained its significance as a considerable and independent prognostic factor of 5-year OS rate (HR: 3.173; 95%-CI [1.436-7.010]; p=0.004) but not for univariate 5-year PFS rate (HR: 2.033; 95%-CI [0.925-4.468]; p=0.078). 92 patients (61.3%) were assigned to the G-8-non-frail cohort (cut-off value > 14 points) with an increased 5-year PFS and OS rate compared to the 58 patients (38.7%) classified as G-8-frail (PFS: 82.1% vs. 65.4%; p=0.071 and OS: 88.2% vs. 49.7%; p<0.000; respectively).

Conclusion*Preoperative G-8 geriatric score independently predicted 5-year OS in elderly EC patients irrespectively of the maximal surgical effort.

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