Performance of the Vulnerable Elders Survey 13 screening tool in identifying cancer treatment modification after geriatric assessment in pre-treatment patients: A retrospective analysis. Issue 2 (March 2019)

• Record Type: Journal Article
• Authors: Rowbottom, Leigha; Loucks, Allison; Jin, Rana; Breunis, Henriette; Syed, Ali Taqi; Watt, Sarah; Timilshina, Narhari; Puts, Martine; Yokom, Daniel; Berger, Arielle; Alibhai, Shabbir M.H.
• Is Part Of: Journal of geriatric oncology. Volume 10:Issue 2(2019)
• Page Start: 229
• Page End: 234
• Publication Date: 2019-03
• Subjects: Geriatric assessment -- Aged -- Neoplasms -- Medical oncology -- VES-13 -- Modified G8 -- Treatment decision-making -- Screening -- Frailty; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2018.10.018
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Purpose: Geriatric assessment (GA) is recommended for older adults ≥ 70 years with cancer to guide treatment selection. Screening tools such as the Vulnerable Elders Survey (VES-13) and G6 have been used to identify patients at highest need of GA. Whether either tool predicts a change in oncologic treatment following GA is unclear. Methods: Patients attending a geriatric oncology clinic between July 2015 and June 2017 who completed a VES-13 and underwent subsequent GA were included. Clinical information was extracted from a prospectively maintained database. G6 scores were assigned retrospectively. Patients were stratified into those who were "VES-13 positive" (score ≥ 3) and "VES-13 negative" (score < 3). Logistic regression was used to explore the relationship between VES-13 score, G6 score, and treatment modification. Results: Ninety-nine patients were seen prior to initiating cancer treatment. The median VES-13 score was 7; with 81.8% of patients scoring ≥3. The treatment plan was modified in 47.5% of patients after GA. VES-13 score was predictive of treatment plan modification (63.0% among VES-13 positive versus 16.7% among VES-13 negative patients; p = 0.001). G6 performed similarly to the VES-13. The only statistically significant predictor of treatment change in multivariable analysis was performance status. Conclusion: VES-13 positive patients are more likely to undergo treatment modification to reduce treatment intensity or supportive care only. The VES-13 may provide oncologists with a rapid, reliable way of identifying vulnerability in older adults with cancer who may need further GA prior to commencing cancer treatment.