Prognostic information is needed to balance benefits and risks of cancer treatment in older patients. Metabolomics-based scores were previously developed to predict 5- and 10-year mortality (MetaboHealth) and biological age (MetaboAge). This study aims to investigate the association of MetaboHealth and MetaboAge with 1-year mortality in older patients with solid tumors, and to study their predictive value for mortality in addition to established clinical predictors. This prospective cohort study included patients aged ≥ 70 years with a solid malignant tumor, who underwent blood sampling and a geriatric assessment before treatment initiation. The outcome was all-cause 1-year mortality. Of the 192 patients, the median age was 77 years. With each SD increase of MetaboHealth, patients had a 2.32 times increased risk of mortality (HR 2.32, 95% CI 1.59–3.39). With each year increase in MetaboAge, there was a 4% increased risk of mortality (HR 1.04, 1.01–1.07). MetaboHealth and MetaboAge showed an AUC of 0.66 (0.56–0.75) and 0.60 (0.51–0.68) for mortality prediction accuracy, respectively. The AUC of a predictive model containing age, primary tumor site, distant metastasis, comorbidity, and malnutrition was 0.76 (0.68–0.83). Addition of MetaboHealth increased AUC to 0.80 (0.74–0.87) (p = 0.09) and AUC did not change with MetaboAge (0.76 (0.69–0.83) (p = 0.89)). Higher MetaboHealth and MetaboAge scores were associated with 1-year mortality. The addition of MetaboHealth to established clinical predictors only marginally improved mortality prediction in this cohort with various types of tumors. MetaboHealth may potentially improve identification of older patients vulnerable for adverse events, but numbers were too small for definitive conclusions. The TENT study is retrospectively registered at the Netherlands Trial Register (NTR), trial number NL8107. Date of registration: 22–10-2019.

需要预后信息来平衡老年患者癌症治疗的益处和风险。以前开发了基于代谢组学的评分来预测 5 年和 10 年死亡率 （MetaboHealth） 和生物年龄 （MetaboAge）。本研究旨在调查 MetaboHealth 和 MetaboAge 与老年实体瘤患者 1 年死亡率的相关性，并研究除已建立的临床预测因子外，它们对死亡率的预测价值。这项前瞻性队列研究包括 ≥ 70 岁的实体恶性肿瘤患者，他们在治疗开始前接受了血液采样和老年评估。结果是全因 1 年死亡率。在 192 名患者中，中位年龄为 77 岁。MetaboHealth 每增加一个 SD，患者的死亡风险就会增加 2.32 倍 （HR 2.32,95% CI 1.59-3.39）。随着 MetaboAge 的逐年增加，死亡风险增加 4% （HR 1.04， 1.01–1.07）。MetaboHealth 和 MetaboAge 的死亡率预测准确性分别为 0.66 （0.56-0.75） 和 0.60 （0.51-0.68）。包含年龄、原发肿瘤部位、远处转移、合并症和营养不良的预测模型的 AUC 为 0.76 （0.68-0.83）。添加 MetaboHealth 将 AUC 增加到 0.80 （0.74–0.87） （p = 0.09），并且 AUC 不随 MetaboAge 变化 （0.76 （0.69–0.83） （p = 0.89））。较高的 MetaboHealth 和 MetaboAge 评分与 1 年死亡率相关。将 MetaboHealth 添加到已建立的临床预测因子中，仅略微改善了该队列中各种类型肿瘤的死亡率预测。MetaboHealth 可能会改善对易发生不良事件的老年患者的识别，但数字太小，无法得出明确的结论。 TENT 研究在荷兰试验注册库 （NTR） 进行回顾性注册，试验编号为 NL8107。注册日期：2019 年 10 月 22 日至 10 日。