Abstract
Introduction
Comprehensive Geriatric Assessment (CGA) should be considered in all older patients with a cancer diagnosis. Initial frailty screening may highlight those who would benefit most from CGA to optimise their health through radical treatment.
The G8 score assesses multiple domains and has been validated in oncology patients: lower scores indicate frailty. In contrast the CFS is not specifically targeted at cancer patients and is often unfamiliar to oncologists.
OACOS does not currently utilise the G8 or CFS in its referral criteria; oncologists refer based on concerns for patients undertaking radical treatment.
Methods
Between September 2022 and March 2024, 68 patients were assessed by the OACOS and 49 patients seen in clinic. 100% of patients had a CFS calculated, 92% had a G8 recorded.
12 month follow up was completed on all patients to review outcomes, including complications of radical treatment, toxicities, changes to treatment, and changes to independent living status. Analysis was then sub-divided by G8 score and CFS.
Results
In patients with a CFS of 1-2, 50% experienced complications of oncology treatments compared to 71% of those with CFS 5-6. 83% with CFS 1-2 completed treatment, compared to 21% with CFS 5-6. 36% with CFS 5-6 had a change in independent living status. 50% with CFS 5-6 had treatment downgraded as a result of CGA outcome.
25% with a G8 of 12-14 had treatment downgraded, while 57% with G8 9-11 had treatment downgraded or stopped. Of those with G8 12-14, 75% completed treatment, whereas 29% of those with G8 of 9-11 completed treatment.
Conclusion(s)
As expected, those with either a CFS or G8 score that indicated frailty had worse outcomes in this population. The use of CFS and G8 now needs to be considered as part of the referral criteria to ensure optimal utilisation of OACOS resources.