Predictive Value of G8 Screening for Early Discontinuation of Gastric Cancer Adjuvant Chemotherapy

Background/Aim: Adjuvant chemotherapy is the standard of care for stage II-III gastric cancer; however, treatment discontinuation is frequently observed in elderly patients. This study aimed to evaluate the association between the G8 screening tool and the continuation of adjuvant chemotherapy in elderly patients with gastric cancer. Patients and Methods: We retrospectively reviewed 40 patients (age ≥70 years) who underwent curative gastrectomy followed by adjuvant chemotherapy. The G8 score was assessed preoperatively. Receiver operating characteristic curve analysis was used to determine the optimal cut-off value, and logistic regression was used to identify predictors of treatment discontinuation. Results: The optimal G8 cut-off was 12 (area under the curve 0.72). Adjuvant chemotherapy was discontinued owing to adverse events in 37.5% of patients. Patients with G8 <12 had a significantly higher discontinuation rate than those with G8 ≥12 (85.7% vs. 27.3%; p=0.001). Multivariable analysis identified G8 <12 as a significant predictor of treatment discontinuation (odds ratio 9.5; 95% confidence interval=1.1-205; p=0.04). Furthermore, G8 <12 was significantly associated with shorter treatment duration (p=0.0032). Conclusion: A low preoperative G8 score was associated with early discontinuation of adjuvant chemotherapy in elderly patients with gastric cancer. Preoperative G8 screening may help identify vulnerable patients who may require careful perioperative management and individualized treatment strategies.