Clinical Epidemiology and Ageing

Development, validation and clinical impact of a prediction model for 6-month mortality in older cancer patients: the GRADE.

Angeli E, Chouahnia K, Canoui-Poitrine F, Duchemann B, Aparicio T, Paillaud E, Zelek L, Bousquet G, Pamoukdjian F Aging (Albany NY). 2020;12(5):4230-4246.

BACKGROUND: To develop, validate, and assess the clinical impact of a clinical score to predict a 6-month mortality risk among older cancer patients.

RESULTS: The mean age was 81.2 ± 6.1 years (women: 54%, various cancers, metastatic cancer: 45%). The score, namely the GRADE, included two geriatric variables (unintentional weight loss, impaired mobility), two oncological variables (cancer site, cancer extension), and exclusively supportive care. Up to a 14% risk of early death, the decision curves suggest that cancer treatment should be instated.

CONCLUSION: We have developed and validated a simple score, easy to implement in daily oncological practice, to predict early death among older cancer patients which could guide oncologists in their treatment decisions.

METHODS: 603 outpatients prospectively included in the Physical Frailty in Elderly Cancer patients cohort study. We created a multivariate prediction model by evaluating the strength of the individual components of the Geriatric Assessment regarding risk of death at 6 months. Each component was evaluated by univariate analysis and the significant variables ( ≤ 0.20) were carried on as covariates in the multivariate cox proportion hazard analysis. The beta coefficients from the model were used to build a point-based scoring system. Clinical impact was assessed using decision curves.

MeSH terms: Age Factors; Aged; Aged, 80 and over; Female; Geriatric Assessment; Humans; Male; Models, Theoretical; Neoplasms; Prognosis; Risk Assessment; Survival Rate
DOI: 10.18632/aging.102876