Geriatric Assessment and Cancer Survival Prediction by the Vulnerable Elders Survey-13 Screening Tool: A Systematic Review and Meta-Analysis.

OBJECTIVES: The Vulnerable Elders Survey-13 (VES-13) is a tool for identifying patients aged 65 years and older at high risk of adverse outcomes who may require a comprehensive geriatric assessment (CGA). We evaluated the diagnostic and prognostic value of the VES-13 score in cancer. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: Patients with cancer. METHODS: We systematically searched PubMed, Embase, and the Cochrane Library databases and conducted meta-analyses exploring the diagnostic and prognostic value of the VES-13 score for progression-free survival or overall survival, respectively, of patients with cancer. The predictive value of VES-13 scores for adverse events, discontinuation of treatment, and dose reduction was also investigated. RESULTS: Our meta-analysis revealed moderate VES-13 diagnostic accuracy across 36 studies (7,110 patients) for CGA abnormalities (diagnostic odds ratio = 1.93, 95% Confidence Interval [CI], 1.66-2.19). High VES-13 scores predicted significantly poor OS (hazard ratio [HR]=1.68, 95% CI, 1.53-1.84; p< .001) but did not significantly predict PFS (HR = 1.28, 95% CI, 0.85-1.94; P= .240). Patients with high VES-13 scores displayed a high rate of adverse events (pooled odds ratio [OR] = 4.29, 95% CI, 1.39-13.23) and dose reduction (pooled OR = 2.24, 95%CI, 1.15-4.37). CONCLUSIONS AND IMPLICATIONS: The VES-13 score demonstrates moderate diagnostic accuracy for CGA abnormalities and may serve as a potential prognostic predictor for patients with cancer.