Evaluación del test G8 como tamizaje para Valoración geriátrica integral en pacientes adultos mayores con cáncer
Palabras clave:
Evaluación Geriátrica, Neoplasmas, Detección Precoz del Cáncer, Sensibilidad y Especificidad, Fragilidad, Área Bajo la Curva
Resumen
Objetivo: evaluar la sensibilidad y especificidad del test G8 en el tamizaje de adultos mayores con cáncer para la realización de la valoración geriátrica integral (VGI). Materiales y métodos: el presente estudio observacional y retrospectivo se realizó en el Servicio de Geriatría del Hospital Almenara de Lima, Perú. Se revisaron los informes de VGI en las historias clínicas electrónicos de adultos mayores (> 60 años) con cáncer, ambulatorios y hospitalizados, durante noviembre de 2022 y julio de 2023. Los pacientes se clasificaron según los criterios SIOG-1 (Sociedad Internacional de Oncología Geriátrica), formando dos grupos: pacientes aptos y pacientes no aptos o unfit (vulnerables + frágiles + muy enfermos). Del test G8 se estimó la sensibilidad, especificidad y valor predictivo positivo, área bajo la curva característica operativa del receptor (AUC). Resultados: ingresaron al estudio 201 pacientes, 91 mujeres (45,3%) y 110 (54,7%) varones, la media de la edad fue de 76,2 ± 7,4 años. Las neoplasias más frecuentes fueron colorrectal, estómago, próstata y vías biliares. La prevalencia de pacientes aptos y no aptos (unfit) fue del 23,4 y 76,6%, respectivamente. Cuando el puntaje de la prueba G8 fue ≤11, la sensibilidad, especificidad, valor predictivo positivo y AUC fueron 73,4% (intervalo de confianza al 95%: 65,7-80,2%), 91,5% (79,6%-97,6%), 96,6% (91,7-98,6%) y 89% (84-93%), respectivamente. Conclusiones: el test G8 con puntaje ≤11 tendría una alta sensibilidad y especificidad, para identificar adultos con cáncer vulnerables o frágiles, que podrían beneficiarse de la VGI.
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16. Ferrat E, Paillaud E, Caillet P, Laurent M, Tournigand C, Lagrange J-L, et al. Performance of Four Frailty Classifications in Older Patients With Cancer: Prospective Elderly Cancer Patients Cohort Study. J Clin Oncol [Internet]. 2017 Mar 1;35(7):766–77. Available from: https://ascopubs.org/doi/10.1200/JCO.2016.69.3143
17. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ [Internet]. 2015 Oct 28;h5527. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.h5527
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19. Lobo A, Saz P, Marcos G, Día JL, de la Cámara C, Ventura T, et al. [Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population]. Med Clin (Barc) [Internet]. 1999 Jun 5;112(20):767–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10422057
20. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF). Journals Gerontol Ser A Biol Sci Med Sci [Internet]. 2001 Jun 1;56(6):M366–72. Available from: https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/56.6.M366
21. Raynaud-Simon A, Revel-Delhom C, Hébuterne X. Clinical practice guidelines from the French health high authority: Nutritional support strategy in protein-energy malnutrition in the elderly. Clin Nutr [Internet]. 2011 Jun;30(3):312–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0261561410002153
22. García González J V, Díaz Palacios E, Salamea García A, Cabrera González D, Menéndez Caicoya A, Fernández Sánchez A, et al. [An evaluation of the feasibility and validity of a scale of social assessment of the elderly]. Aten primaria [Internet]. 1999 Apr 30;23(7):434–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10363397
23. Bell CC. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. JAMA J Am Med Assoc [Internet]. 1994 Sep 14;272(10):828. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1994.03520100096046
24. Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research: Application of the Cumulative Illness Rating Scale. Psychiatry Res [Internet]. 1992 Mar;41(3):237–48. Available from: https://linkinghub.elsevier.com/retrieve/pii/016517819290005N
25. Droz J, Balducci L, Bolla M, Emberton M, Fitzpatrick JM, Joniau S, et al. Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int [Internet]. 2010 Aug 23;106(4):462–9. Available from: https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09334.x
26. Baitar A, Van Fraeyenhove F, Vandebroek A, De Droogh E, Galdermans D, Mebis J, et al. Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer. J Geriatr Oncol [Internet]. 2013 Jan;4(1):32–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1879406812000768
27. Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H, et al. Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study. Williams BO, editor. PLoS One [Internet]. 2014 Dec 11;9(12):e115060. Available from: https://dx.plos.org/10.1371/journal.pone.0115060
28. Marenco D, Marinello R, Berruti A, Gaspari F, Stasi MF, Rosato R, et al. Multidimensional geriatric assessment in treatment decision in elderly cancer patients: 6-year experience in an outpatient geriatric oncology service. Crit Rev Oncol Hematol [Internet]. 2008 Nov;68(2):157–64. Available from: https://linkinghub.elsevier.com/retrieve/pii/S104084280800142X
2. Rostoft S, O’Donovan A, Soubeyran P, Alibhai SMH, Hamaker ME. Geriatric Assessment and Management in Cancer. J Clin Oncol [Internet]. 2021 Jul 1;39(19):2058–67. Available from: https://ascopubs.org/doi/10.1200/JCO.21.00089
3. Oscanoa TJ, Vidal X, Beltran BE, Romero-Ortuno R. Comprehensive geriatric assessment and clinical outcomes of frail older adults with diffuse large B-cell lymphoma: a meta-analysis. Oncol Clin Pract [Internet]. 2023 Dec 19;19(6):398–412. Available from: https://journals.viamedica.pl/oncology_in_clinical_practice/article/view/94673
4. Oscanoa TJ, Romero-Ortuno R. The identification of frailty in older people living with diffuse large B-cell lymphoma: a systematic review. Acta Haematol Pol [Internet]. 2023 Nov 7; Available from: https://journals.viamedica.pl/acta_haematologica_polonica/article/view/94456
5. Horgan AM, Leighl NB, Coate L, Liu G, Palepu P, Knox JJ, et al. Impact and Feasibility of a Comprehensive Geriatric Assessment in the Oncology Setting. Am J Clin Oncol [Internet]. 2012 Aug;35(4):322–8. Available from: https://journals.lww.com/00000421-201208000-00004
6. Corre R, Greillier L, Le Caër H, Audigier-Valette C, Baize N, Bérard H, et al. Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study. J Clin Oncol [Internet]. 2016 May 1;34(13):1476–83. Available from: https://ascopubs.org/doi/10.1200/JCO.2015.63.5839
7. Hamaker ME, Wildes TM, Rostoft S. Time to Stop Saying Geriatric Assessment Is Too Time Consuming. J Clin Oncol [Internet]. 2017 Sep 1;35(25):2871–4. Available from: https://ascopubs.org/doi/10.1200/JCO.2017.72.8170
8. González Serrano A, Laurent M, Barnay T, Martínez-Tapia C, Audureau E, Boudou-Rouquette P, et al. A Two-Step Frailty Assessment Strategy in Older Patients With Solid Tumors: A Decision Curve Analysis. J Clin Oncol [Internet]. 2023 Feb 1;41(4):826–34. Available from: https://ascopubs.org/doi/10.1200/JCO.22.01118
9. Garcia M V., Agar MR, Soo W-K, To T, Phillips JL. Screening Tools for Identifying Older Adults With Cancer Who May Benefit From a Geriatric Assessment. JAMA Oncol [Internet]. 2021 Apr 1;7(4):616. Available from: https://jamanetwork.com/journals/jamaoncology/fullarticle/2774872
10. Saliba D, Elliott M, Rubenstein LZ, Solomon DH, Young RT, Kamberg CJ, et al. The Vulnerable Elders Survey: A Tool for Identifying Vulnerable Older People in the Community. J Am Geriatr Soc [Internet]. 2001 Dec;49(12):1691–9. Available from: http://doi.wiley.com/10.1046/j.1532-5415.2001.49281.x
11. Bellera CA, Rainfray M, Mathoulin-Pélissier S, Mertens C, Delva F, Fonck M, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol [Internet]. 2012 Aug;23(8):2166–72. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0923753419381025
12. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition [Internet]. 1999 Feb;15(2):116–22. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0899900798001713
13. Zhao H, Lu X, Zheng S, Wei D, Zhao L, Wang Y, et al. Comparison of two frailty screening tools in older patients with colorectal cancer. BMC Geriatr [Internet]. 2023 May 15;23(1):295. Available from: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-03974-3
14. Droz J-P, Balducci L, Bolla M, Emberton M, Fitzpatrick JM, Joniau S, et al. Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int [Internet]. 2010 Aug;106(4):462–9. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09334.x
15. Droz J-P, Aapro M, Balducci L, Boyle H, Van den Broeck T, Cathcart P, et al. Management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology. Lancet Oncol [Internet]. 2014 Aug;15(9):e404–14. Available from: https://linkinghub.elsevier.com/retrieve/pii/S147020451470018X
16. Ferrat E, Paillaud E, Caillet P, Laurent M, Tournigand C, Lagrange J-L, et al. Performance of Four Frailty Classifications in Older Patients With Cancer: Prospective Elderly Cancer Patients Cohort Study. J Clin Oncol [Internet]. 2017 Mar 1;35(7):766–77. Available from: https://ascopubs.org/doi/10.1200/JCO.2016.69.3143
17. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ [Internet]. 2015 Oct 28;h5527. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.h5527
18. Katz S. Studies of Illness in the Aged. JAMA [Internet]. 1963 Sep 21;185(12):914. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1963.03060120024016
19. Lobo A, Saz P, Marcos G, Día JL, de la Cámara C, Ventura T, et al. [Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population]. Med Clin (Barc) [Internet]. 1999 Jun 5;112(20):767–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10422057
20. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF). Journals Gerontol Ser A Biol Sci Med Sci [Internet]. 2001 Jun 1;56(6):M366–72. Available from: https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/56.6.M366
21. Raynaud-Simon A, Revel-Delhom C, Hébuterne X. Clinical practice guidelines from the French health high authority: Nutritional support strategy in protein-energy malnutrition in the elderly. Clin Nutr [Internet]. 2011 Jun;30(3):312–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0261561410002153
22. García González J V, Díaz Palacios E, Salamea García A, Cabrera González D, Menéndez Caicoya A, Fernández Sánchez A, et al. [An evaluation of the feasibility and validity of a scale of social assessment of the elderly]. Aten primaria [Internet]. 1999 Apr 30;23(7):434–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10363397
23. Bell CC. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. JAMA J Am Med Assoc [Internet]. 1994 Sep 14;272(10):828. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1994.03520100096046
24. Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research: Application of the Cumulative Illness Rating Scale. Psychiatry Res [Internet]. 1992 Mar;41(3):237–48. Available from: https://linkinghub.elsevier.com/retrieve/pii/016517819290005N
25. Droz J, Balducci L, Bolla M, Emberton M, Fitzpatrick JM, Joniau S, et al. Management of prostate cancer in older men: recommendations of a working group of the International Society of Geriatric Oncology. BJU Int [Internet]. 2010 Aug 23;106(4):462–9. Available from: https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09334.x
26. Baitar A, Van Fraeyenhove F, Vandebroek A, De Droogh E, Galdermans D, Mebis J, et al. Evaluation of the Groningen Frailty Indicator and the G8 questionnaire as screening tools for frailty in older patients with cancer. J Geriatr Oncol [Internet]. 2013 Jan;4(1):32–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1879406812000768
27. Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H, et al. Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study. Williams BO, editor. PLoS One [Internet]. 2014 Dec 11;9(12):e115060. Available from: https://dx.plos.org/10.1371/journal.pone.0115060
28. Marenco D, Marinello R, Berruti A, Gaspari F, Stasi MF, Rosato R, et al. Multidimensional geriatric assessment in treatment decision in elderly cancer patients: 6-year experience in an outpatient geriatric oncology service. Crit Rev Oncol Hematol [Internet]. 2008 Nov;68(2):157–64. Available from: https://linkinghub.elsevier.com/retrieve/pii/S104084280800142X
Publicado
2024-03-30
Cómo citar
1.
Oscanoa TJ, Cieza-Macedo E, Leon-Curiñaupa S, Amado-Tineo J. Evaluación del test G8 como tamizaje para Valoración geriátrica integral en pacientes adultos mayores con cáncer. Acta Med Peru [Internet]. 30 de marzo de 2024 [citado 28 de septiembre de 2024];41(1). Disponible en: https://amp.cmp.org.pe/index.php/AMP/article/view/2904
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