Functional status and mortality in older women with gynecological cancer

Background. Screening tools for the identification of vulnerable older patients with cancer are needed. Aim of this study is to measure the prognostic value of multiple screening tools for the assessment of mortality risk in oncogeriatrics.Methods. The prognostic value of the following assessment tools was tested in 200 older women with gynecological cancer (mean age = 73.5 years) for 1-year mortality: Short Physical Performance Battery, usual gait speed, handgrip strength, Eastern Cooperative Oncology Group Performance Status scale, Karnofsky Performance Status scale, Vulnerable Elders Scale-13, activities of daily living, and instrumental activities of daily living. Cox proportional hazard models were performed to estimate the associations of the performance measures with mortality. Areas under receiver operating characteristic curves were also estimated.Results. Twenty-three participants (11.5%) died during the follow-up. The Short Physical Performance Battery, usual gait speed, and instrumental activities of daily living were the only parameters significantly associated with mortality, even after adjustment for confounders. No statistically significant results were reported for other functional measures. Similar results were obtained when testing the predictive values of the performance measures at the receiver operating characteristic analyses.Conclusions. The Short Physical Performance Battery and especially the usual gait speed may represent promising tools for measuring the mortality risk of older cancer patients, thus potentially supporting clinical decisions. Further studies are needed to confirm and extend the present findings.