Prognostic Value of the B12/CRP Index in Older Systemically Treatable Cancer Patients

authors

• Montegut Coline
• Correard Florian
• Nouguerède Emilie
• Rey Dominique
• Chevalier Thomas
• Meurer Marie
• Deville Jean-Laurent
• Baciuchka Marjorie
• Pradel Vincent
• Greillier Laurent
• Villani Patrick
• Couderc Anne-Laure

keywords

• Frailty
• Older patient
• Medical oncology
• C-reactive protein
• Serum vitamin B12 level

document type

abstract

Background: While comprehensive geriatric assessment (CGA) in older patients treated for cancer assesses several related domains, it does not include standardized biological tests. The present study aimed to: (1) assess the prognosis value of the B12/CRP index (BCI) in a population of systemically treatable older patients with cancer and (2) analyze the association between BCI value and pre-existing geriatric frailty. Method: We conducted a retrospective observational study between January 2016 and June 2020 at Marseille University Hospital. All consecutive cancer patients aged 70 years and over before initiating systemic therapy were included. Results: Of the 863 patients included, 60.5% were men and 42.5% had metastatic stage cancer. Mean age was 81 years. The low-BCI group (≤10,000) had a significantly longer survival time than the mid-BCI (10,000 < BCI ≤ 40,000) and high-BCI (BCI > 40,000) groups (HR = 0.327, CI95% [0.26–0.42], p-value = 0.0001). Mid- and high-BCI (BCI > 40,000) values were associated with impaired functional status and malnutrition. Conclusion: A BCI > 10,000 would appear to be a good biological prognostic factor for poor survival times and pre-existing geriatric impairment in older cancer patients before they initiate systemic treatment.

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