Predicting 1-year mortality in older cancer patients: performance of G8, SPPB, and IF-VIG in the PROFIT Study

Background: Frailty is a prognostic determinant in older patients, yet the most effective tools to predict survival remain unclear. This study aimed to assess the predictive performance of different frailty assessment tools for 1-year mortality in the oncogeriatric population. Methods: A multicenter cohort study (PROFIT Study) involved patients aged ≥65 with cancer, evaluated in oncology clinics and post-acute oncogeriatric units. Frailty was measured using the Geriatric 8 questionnaire (G8), Short Physical Performance Battery (SPPB), and the Frailty Index Indice Frágil—Valoración Integral Geriátrica (IF-VIG). One-year mortality was monitored. Predictive ability was analyzed using receiver operating characteristic curves with optimized cut-offs, and covariate-adjusted Cox regression models were used to evaluate the association between frailty and mortality. Results: Among 229 patients (mean age 75.1 ± 6.4 years; 68.6% male; cancer type: 47.2% lung cancer, 17.9% colorectal, 25.3% other gastrointestinal, 9.6% prostate; tumoral stage IV: 85.2%), 146 (63.7%) died within 1 year. All tools showed predictive value, with IF-VIG demonstrating the highest sensitivity and SPPB the highest specificity. Optimized cut-offs improved performance compared to standard thresholds (G8: 12.5 vs 14; SPPB: 8 vs 9; IF-VIG: 0.16 vs 0.25). Adjusted Cox models confirmed significant associations with 1-year mortality: hazard ratio [HR] 1.97 (95% CI 1.30–2.99) for G8, 2.35 (95% CI 1.52–3.64) for SPPB, and 2.42 (95% CI 1.50–3.90) for IF-VIG. Conclusions: All frailty tools were significantly associated with 1-year mortality. SPPB and IF-VIG outperformed G8 in prognostic accuracy, highlighting their potential utility in clinical decision-making for older patients with cancer.