Elham ARIF, Mohamed Mortada Mohamed GODA, Heba ALY, Marwa Ahmed MOHAMED, Dina FATHY
European Journal of Geriatrics and Gerontology - 2026;8(1):14-25
Objective: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common in Egypt. Studies report a significant age-specific increase in HCC development. Sorafenib is frequently used to treat patients with HCC across all age groups, including the elderly. Assessing treatment tolerability, quality of life (QoL), and symptom burden in older patients is crucial because frailty is more prevalent with advancing age and can lead to poorer outcomes. The G8 has demonstrated superior prediction of complications and symptom burden among older adults with various cancers. Therefore, our primary aim is to assess G8 frailty tool as predictor of QoL in elderly patients with HCC receiving sorafenib. Our secondary aim was to assess the correlation between G8 and side effects and decompensation during sorafenib treatment. Materials and Methods: The study subjects were elderly patients (aged 60 years or older) presenting to HCC outpatient clinics at Ain Shams University who were eligible for sorafenib. Patients were initiated on sorafenib and followed for three months. G8 was assessed before the first dose of sorafenib. European Organization for Research and Treatment of Cancer Quality of Life 15 items Questionnaire for Palliative Care scores and timed up and go test (TUGT) were assessed before the first dose and repeated after one and three months of treatment. Data were tabulated and statistically analyzed using SPSS version 29 (SPSS Inc., Chicago, IL). Results: Mean G8 score was 12.98 +/- 2.61 (7-17). No statistically significant differences were noted in patients' QoL when assessed before starting sorafenib treatment and during follow-up. A worse G8 score was significantly associated with poorer physical function, as measured by TUGT, in all three encounters. Moreover, lower G8 scores were significantly correlated with worse QoL subscale scores during most follow-up encounters. Additionally, worse G8 scores were correlated with greater side effects after 3 months of treatment. Conclusion: In elderly patients with HCC, G8 can predict QoL and symptom burden during sorafenib treatment. These findings highlight the importance of incorporating frailty assessments into routine clinical practice to guide personalized care for this vulnerable population.
