Comparison of two frailty screening tools in older patients with colorectal cancer.

ABSTRACT

INTRODUCTION: Geriatric assessment (GA) is widely used to detect vulnerability in older patients. As this process is time-consuming, prescreening tools have been developed to identify patients at risk for frailty. We aimed to assess whether the Geriatric 8 (G8) or the Korean Cancer Study Group Geriatric Score (KG-7) shows better performance in identifying patients who are in need of full GA. MATERIALS AND METHODS: A consecutive series of patients aged ≥ 60 years with colorectal cancer were included. The sensitivity, specificity, predictive value, and 95% confidence intervals (95% CI) were calculated for the G8 and the KG-7 using the results of GA as the reference standard. ROC(Receiver Operating Characteristic) was used to evaluate the accuracy of the G8 and the KG-7. RESULTS: One hundred four patients were enrolled. A total of 40.4% of patients were frail according to GA, and 42.3% and 50.0% of patients were frail based on the G8 and the KG-7, respectively. The sensitivity and specificity of the G8 were 90.5% (95% CI 77.4-97.3%) and 90.3% (95% CI 80.1-96.4%), respectively. For the KG-7, the sensitivity and specificity were 83.3% (95% CI 68.6-93.0%) and 72.6% (95% CI 59.8-83.1%), respectively. Compared to the KG-7, the G8 had a higher predictive accuracy (AUC (95% CI) 0.90 (0.83-0.95) vs. 0.78 (0.69-0.85); p < 0.01). By applying the G8 and the KG-7, 60 and 52 patients would not need a GA assessment, respectively. CONCLUSION: Both the G8 and the KG-7 showed a great ability to detect frailty in older patients with colorectal cancer. In this population, compared to the KG-7, the G8 had a better performance in identifying those in need of a full Geriatric Assessment.