Determination of an adequate screening tool for identification of vulnerable elderly head and neck cancer patients treated with radio(chemo)therapy

Lies Pottel, Tom Boterberg, Hans Pottel, Laurence Goethals, Nele Van Den Noortgate, Fréderic Duprez, Wilfried De Neve, Sylvie Rottey, Kurt Geldhof, Koen Van Eygen, Khalil Kargar-Samani, Véronique Ghekiere, Frank Cornelis, Supriya Mohile, Philip R. Debruyne*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)24-32
Number of pages9
JournalJournal of Geriatric Oncology
Volume3
Issue number1
DOIs
Publication statusPublished - Jan 2012
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Geriatrics and Gerontology

Keywords

  • Comprehensive geriatric assessment
  • Elderly
  • G8
  • Head and neck cancer
  • Radiotherapy
  • Screening instrument
  • Vulnerable
  • Vulnerable Elders Survey-13

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