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Utilidad del cuestionario g8 en la predicción de fragilidad en pacientes ancianos con cáncer de próstata metastásico o resistente a castración

Publicado en:ARCHIVOS ESPANOLES DE UROLOGIA. 75 (3): 235-247 - 2022-01-01 75(3), DOI:

Autores: Ríos González, Emilio; Linares Espinós, Estefanía; Ramírez, Raquel; Menéndez Colino, Rocío; González Montalvo, Juan Ignacio; Martínez-Piñeiro Lorenzo, Luis

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OBJECTIVE: to assess the capacity of the G8 questionnaire for the detection of frailty in patients over 75 years of age with metastatic or castration resistant prostate cancer and the relationship of the results of this questionnaire with clinical variables, laboratory data, quality of life, functional status and comorbidity. MATERIAL AND METHODS: Patients over the age of 75 with metastatic or castration-resistant prostate cancer were evaluated using the G8 questionnaire. Those with a G8 < 15 were subjected to comprehensive geriatric assessment in order to evaluate the ability of this questionnaire to predict frailty. We studied the relationship between G8 score and functional status (ECOG), comorbidity (Charlson index), quality of life (FACT-P and EQ5D 3L questionnaires), disease characteristics and common analytical variables. RESULTS: 64 patients were included in the study, of whom 26 scored < 15 in the G8 questionnaire and were referred to geriatrics. 89% (23/26) of the patients with a G8 score <15 had fragility data (11 pre-fragile and 7 fragile) and only 11% (3/26) were considered robust. The multivariate model shows that the Charlson index and the EQ5D 3L score are independent predictors of frailty. The Charlson index (OR=1.68, p=0.022) increases the probability that the patient has a G8 score <15 and on the contrary the EQ5D-3L score (OR-0.64, p-0.021) decreases that probability. Both quantitative variables were recoded into binary variables from the most predictive point obtained from the ROC curves and included in a model: patients with Charlson index ≥4 (OR=3.17, p=0.047) and those with EQ5D- 3L score <0.87 (OR=3.35, p=0.037) increased the likelihood of obtaining a G8 score<15. Patients without any of these conditions (neither Charlson ≥4 nor EQ5D-3L score <0.87) have a 19% chance of presenting a G8 score < 15. However, the presence of the two conditions increases the probability to 71.5%. CONCLUSIONS: The score obtained in the G8 questionnaire is a good predictor of frailty in elderly patients with advanced prostate cancer. Comorbidity, as measured by Charlson’s index, and quality of life, as measured by the EQ5D-3L questionnaire, are independent predictors of frailty (score on the G8 questionnaire below 15).

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