INTRODUCTION
Frailty assessment has proved useful for evaluating the ability to withstand cancer treatments, but it remains understudied in low- and middle-income countries, where the average life expectancy is about two decades lower than in higher-income countries. This study aimed to establish frailty cutoffs to guide treatment decisions by determining optimal G8 (Geriatric 8) and SCOPE-C (SCreening of the Older Person with Cancer) scores to predict postoperative outcomes in older Indian adults with head and neck cancer.
MATERIALS AND METHODS
In a tertiary care cancer facility in North India, patients ≥60 years with primary head and neck cancers undergoing curative surgery were included. This prospective observational study took place from January 2024 to March 2025. Pre-surgical frailty assessment was done by G8 and SCOPE-C. The main outcomes were major surgical complications and 30-day readmission.
RESULTS
Of 115 patients included (mean age 66.9 years; 79.1% male), 22.6% developed major complications and 7.8% required readmission. On multivariable analysis, lower G8 (odds ratio [OR] 0.77, p = 0.007) and flap use (OR 3.21, p = 0.048) predicted major complications, while G8 alone predicted readmissions (OR 0.52, p = 0.001). Receiver operating characteristic analysis identified G8 cutoffs of ≤13 score for predicting complications (area under the curve [AUC] 0.636) and ≤ 11 for readmissions (AUC 0.839). Patients with G8 ≤ 11 had higher readmission rates (17% vs 1.5%; p = 0.003), and G8 ≤ 13 had more major complications (28.8% vs 11.9%; p = 0.04).
DISCUSSION
Compared to the SCOPE-C screening tool, the G8 demonstrated statistically significant predictive value for both major surgical complications and readmissions; however, its low AUC indicates limited sensitivity and guarded clinical usefulness in predicting major postoperative complications.
Amit Kumar, Rajeev Kumar, P. Sagar et al.· Journal of Geriatric Oncolog...· 0 citations
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Sneha Verma, Nidhi Srivastava, Anurag Rawat et al.· Journal of Applied Biology &...· 0 citations
