Clinical significance of the G8 screening tool in elderly patients with oral squamous cell carcinoma

  • Shin-ichi YamadaEmail author
  • Takumi Hasegawa
  • Kohei Okuyama
  • Nobuhiro Yamakawa
  • Masaya Okura
  • Masao Hashidume
  • Souichi Yanamoto
  • Masaya Akashi
  • Tadaaki Kirita
  • Masahiro Umeda
  • Hiroshi Kurita
Original Article



The present study investigated the clinical significance of the G8 screening tool in elderly oral squamous cell carcinoma (OSCC) patients using a multicenter analysis.

Materials and methods

The medical records of 438 primary OSCC patients aged 75 years and older were retrospectively reviewed. To examine the clinical significance of the G8 screening tool in elderly OSCC patients, self-reliance (SR) rates and prognostic factors were statistically analyzed.


The mean score of the G8 screening tool was 10.9 ± 2.93. The SR cut-off value of the G8 score was 9.5 in a receiver operating characteristic curve analysis. Five-year overall survival rates were 40.1% in patients with a G8 score < 9.5 and 58.4% in those with a G8 score ≥ 9.5 (p < 0.01). Five-year cancer-specific rates were 34.3% in patients with a G8 score < 9.5 and 55.7% in those with a G8 score ≥ 9.5 (p < 0.01). Five-year SR rates were 40.7% in patients with a G8 score < 9.5 and 55.3% in those with a G8 score ≥ 9.5 (p < 0.05). A multivariate analysis identified an advanced age (≥ 80 vs < 80; HR, 1.437; 95%CI, 1.181–1.843; p < 0.01), poorer ECOG-PS (2–4 vs 0–1; HR, 1.560; 95%CI, 1.14–2.106; p < 0.01), and standard treatment (non-standard therapy vs standard therapy; HR, 0.598; 95%CI, 0.405–0.910; p < 0.05) as significant independent prognostic factors for SR. A lower G8 score was associated with poorer SR (≥ 9.5 vs < 9.5; HR, 0.765; 95%CI, 0.575–1.034; p = 0.081).


The clinical significance of the G8 score for elderly OSCC patients was demonstrated and its combination with ECOG-PS may be useful for assessing their prognoses.


Oral squamous cell carcinoma G8 screening tool Elderly patients Geriatric assessment 



Oral squamous cell carcinoma


Quality of life


Geriatric assessment


Eastern Cooperative Oncology Group Performance status


Charlson comorbidity index


National Comprehensive Cancer Network


Self-reliance survival


Performance status


Overall survival


Cancer-specific survival


Hazard ratio


95% confidence interval


Author contribution

Conception and design of the study: YS and KH

Analysis and interpretation of data: YS and KH

Collection and assembly of data: YS, HT, OK, YN, OM, HM, YS, AM, KT, and UM

Drafting of the article: YS

Critical revision of the article for important intellectual content: YS

Final approval of the article: KH

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Ethics Committee of the Shinshu University School of Medicine (No. 3391).

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Shin-ichi Yamada
    • 1
    Email author
  • Takumi Hasegawa
    • 2
  • Kohei Okuyama
    • 3
  • Nobuhiro Yamakawa
    • 4
  • Masaya Okura
    • 5
  • Masao Hashidume
    • 1
  • Souichi Yanamoto
    • 6
  • Masaya Akashi
    • 2
  • Tadaaki Kirita
    • 4
  • Masahiro Umeda
    • 6
  • Hiroshi Kurita
    • 1
  1. 1.Department of Dentistry and Oral SurgeryShinshu University School of MedicineMatsumotoJapan
  2. 2.Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineKobeJapan
  3. 3.Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
  4. 4.Department of Oral and Maxillofacial SurgeryNara Medical UniversityKashiharaJapan
  5. 5.The 1st Department of Oral and Maxillofacial Surgery, Graduate School of DentistryOsaka UniversityOsakaJapan
  6. 6.Department of Clinical Oral Oncology, Unit of Translational Medicine, Course of Medical and Dental SciencesNagasaki University Graduate School of Biomedical SciencesNagasakiJapan

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