The Role of the G8 Score in Therapeutic Decisions for Elderly Patients With Colorectal Cancer: Experience From the Department of Medical Oncology, Ibn Sina Military Hospital of Marrakech
Abstract
Introduction: Colorectal cancer predominantly affects older adults. The geriatric assessment tool was developed to identify elderly cancer patients suitable for standard treatment and to guide the optimal treatment plan. Materials and methods: A retrospective pilot study was conducted in the medical oncology department, including patients aged 65 and over treated for colorectal cancer. Results: We identified 88 patients over 65 years of age: 48 (54.5%) had localized disease, and 40 (45.5%) had metastatic disease. Among patients with localized disease, chemotherapy was indicated in 25 patients (52%); of these, 17 (68%) had a G8 score >14. Among patients with a G8 score ≤14 (n = 8), 5 (62.50%) required a dose reduction. Among the metastatic patients, 16 (40%) had a G8 score ≤14. Among those with a G8 score >14, 5 patients (20.83%) subsequently required dose adjustments, compared to 79.17% (n = 19) who received the conventional dose. Conclusion: Several limitations must be highlighted regarding the use of the G8 score in colorectal cancer. First, the majority of published studies are observational, with limited sample sizes and heterogeneous conclusions. Second, there is still no randomized controlled trial formally demonstrating that a G8-guided therapeutic strategy improves overall survival or quality of life compared to standard care.
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References
Stewart B, Wild CP. (2014) : World Cancer Report 2014 (pp. 482-494). Geneva, Switzerland : World Health Organization
Finlayson M. (2005) : Activities of daily living (ADL) and instrumental activities of daily living (IADL) items were stable over time in a longitudinal study on aging. Journal of Clinical Epidemiology. April 2005, Volume 58 Issue 4 :338-349. 10.1016/j.jclinepi.2004.10.008
Carine Bellera, Delphine Praud, Aurélie Petit-Monéger, Pippa McKelvie-Sebileau, Pierre Soubeyran, Simone Mathoulin. (2013) : Barriers to inclusion of older adults in randomised controlled clinical trials on non-Hodgkin’s lymphoma: a systematic review. Cancer Treat Rev. 2013, Volume 39, Issue 7 :812-817. 10.1016/j.ctrv.2013.01.007
Phelip JM, Tougeron D, Léonard D. (2019) : Metastatic colorectal cancer (mCRC): French intergroup clinical practice guidelines for diagnosis, treatment, and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, ACHBT, SFRO, SFR). Dig Liver Dis. 2019, 51 :1357-1363. 10.1016/j.dld.2019.05.035
Wildiers H. (2014) : ESMO-SIOG clinical practice guidelines for the management of older patients with cancer. Ann Oncol. 2014, 32 :844-60. 10.1200/JCO.2013.54.8347
Martine Extermann a, Matti Aapro b, Roberto Bernabei c. (2005) : Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol. 2005, Volume 55, Issue 3 :241-252. 10.1016/j.critrevonc.2005.06.003
Van Cutsem E, Cervantes A. (2022) : Metastatic colorectal cancer : ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023, 34(1) :10-32. 10.1016/j.annonc.2022.10.003
Bellera CA, Rainfray M, Mathoulin-Pelissier S, et al. (2012) : Screening older cancer patients : First evaluation of the G-8 geriatric screening tool. Ann Oncol. 2012, 23 :2166-72. 10.1093/annonc/mdr587
Kurokawa Y. (2023) : G8 score predictions completion of chemotherapy in older cancer patients. Jpn J Clin Oncol. 2023, 53 :1177-84. 10.1093/jjco/hyaf105
Hara K, Chikaishi W, Yamada Y, et al. (2025) : Geriatric 8 score as a prognostic factor of the efficacy and safety of oxaliplatin-based chemotherapy in elderly patients with metastatic colorectal cancer. Int J Colorectal Dis. 2025, 40 :132. 10.1007/s00384-025-04923-9
Mohile SG, Dale W, Somerfield MR, et al. (2018) : Practical assessment and management of vulnerabilities in older patients receiving chemotherapy. J Clin Oncol. 2018, 36:2326-47. 10.1200/JCO.2018.78.8687
Kenis C, Bron D, Libert Y, et al. (2013) : Relevance of a systematic geriatric screening and assessment in older patients with cancer : results of a prospective multicentric study. Ann Oncol. 2013, 24(5) :1306-1312. Doi : 10.1093/annonc/mds619
Aparicio T, Jouve JL, Teillet L, et al. (2013) : Geriatric factors predict chemotherapy feasibility: ancillary results of FFCD 2001-02 phase III study in first-line chemotherapy for metastatic colorectal cancer in elderly patients. J Clin Oncol. 2013, 31(11) :1464-1470. 10.1200/JCO.2012.42.9894
Hamaker ME, Vos AG, Smorenburg CH, de Rooij SE, van Munster BC (2012) : The Value of Geriatric Assessments in Predicting Treatment Tolerance and All-Cause Mortality in Older Patients With Cancer. The Oncologist. 2012, 17(11) :1439-1449. Doi : 10.1634/theoncologist.2012-0186
Copyright (c) 2026 Moussa Abdoul Aziz Sawadogo, Mohamed Kaakoua, Abdoul Malick Tawfik Sore, Hamza Laabbar, Yacine Laouali Abdou, Abdoulkadri Guilley Illiassou, Baztami Youssef, Soukayna Boujmadi, Mohammed Lahkim, Ismail Essadi
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