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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