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

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Angeli, Eurydice | Chouahnia, Kader | Canoui-Poitrine, Florence | Duchemann, Boris | Aparicio, Thomas | Paillaud, Elena | Zelek, Laurent | Bousquet, Guilhem | Pamoukdjian, Frederic

Edité par CCSD ; Impact Journals -

International audience. 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 (P ≤ 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.

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