Clinical utility of the Geriatric-8 in the functional assessment of patients with gynecological cancer aged 75 and older: a retrospective study

Background: The Geriatric-8 (G8) is used for the functional status of older adult patients with cancer. However, its role in treatment decision-making for gynecological malignancies has not been established. Methods: We retrospectively analyzed the data of 180 women aged ≥75 years with gynecological malignancies who underwent initial treatment at our institution between January 2019 and December 2023. Pre-treatment G8 scores were assessed and patients were categorized as fit (G8 > 14) or frail (G8 ≤ 14). Associations between the G8 score and patient background, disease characteristics, treatment options, and treatment tolerability were examined. Results: Of the 180 women, 53 (29.4%) were classified as fit and 127 (70.6%) as frail. Frail patients required long-term care (P = .008) and used anticoagulants more frequently than fit patients (P = .019). Median G8 scores were highest in endometrial cancer (14) and lowest in vulvar cancer (10). Best supportive care (8) and neoadjuvant chemotherapy (10) had lower G8 scores than surgery and concurrent chemoradiotherapy (14) (P < .001). Postoperative complications occurred in 10/96 surgical cases; these cases had lower scores than those without complications (12 vs. 14, P = .044). During chemotherapy, median scores were lower in women with ≥ grade 3 (12 vs. 14, P = .008) and grade ≥ 4 adverse events (10 vs. 14, P = .002). Conclusions: The G8 score is associated with patient background, cancer type, and treatment options, and is associated with treatment tolerability in women aged ≥75 years with gynecological malignancies.