Department of Gerontology and Geriatrics, Leiden University Medical Center, The Netherlands.
Department of Gerontology and Geriatrics, Leiden University Medical Center, The Netherlands.
J Geriatr Oncol. 2018 Nov;9(6):560-568. doi: 10.1016/j.jgo.2018.03.019. Epub 2018 Apr 19.
Older patients with esophageal cancer are at high risk of adverse health outcomes, but the association of geriatric assessment with adverse health outcomes in these patients has not been systematically evaluated. The aim of this systematic review was to study the association of functional and cognitive impairment, social environment and frailty with adverse health outcomes in patients diagnosed with esophageal cancer.
We searched Pubmed, Embase, Web of Science and Cochrane Library for original studies reporting on associations of functional or cognitive impairment, social environment and frailty with adverse outcomes (mortality, functional or cognitive decline, adverse events during treatment, prolonged length of hospitalization (LOS) and health related quality of life (HRQoL)) after follow-up in patients with esophageal cancer.
Of 1.391 identified citations, nineteen articles were included that reported on 53 associations. The median sample size of the included studies was 110 interquartile range (IQR 91-359). Geriatric conditions were prevalent: between 14 and 67% of the included participants were functionally impaired, around 42% had depressive symptoms and between 5 and 23% did not have a partner. In nineteen of 53 (36%) associations functional or cognitive impairment or frailty were significant associated with adverse health outcomes, but the studies were small. In four out of six (67%) associations with the largest sample size (n ≥ 359), functional impairment or social environment were significant associated with adverse health outcomes.
Functional and cognitive impairment, depression and social isolation are prevalent in patients with esophageal cancer, and associate with adverse health outcomes. Geriatric measurements may guide decision-making and customize treatments, but more large studies are needed to explore the clinical usability.
老年食管癌患者健康结局不良的风险较高，但尚未系统评估老年综合评估与这些患者不良健康结局之间的关系。本系统评价的目的是研究功能和认知障碍、社会环境和衰弱与诊断为食管癌患者不良健康结局（死亡率、功能或认知下降、治疗期间不良事件、住院时间延长（LOS）和健康相关生活质量（HRQoL））之间的关系。
我们检索了 Pubmed、Embase、Web of Science 和 Cochrane Library，以获取报告功能或认知障碍、社会环境和衰弱与食管癌患者随访后不良结局（死亡率、功能或认知下降、治疗期间不良事件、住院时间延长（LOS）和健康相关生活质量（HRQoL））之间关系的原始研究。
在 1391 条被识别的引文中有 19 篇文章报道了 53 项相关性研究。纳入研究的中位样本量为 110（四分位距（IQR）91-359）。老年综合评估的情况普遍存在：纳入研究的参与者中，有 14-67%的人功能受损，约 42%的人有抑郁症状，5-23%的人没有伴侣。在 53 项相关性研究中，有 19 项（36%）功能或认知障碍或衰弱与不良健康结局显著相关，但研究规模较小。在 6 项（67%）最大样本量（n≥359）的相关性研究中，功能障碍或社会环境与不良健康结局显著相关。
食管癌患者中功能和认知障碍、抑郁和社会孤立很常见，与不良健康结局相关。老年综合评估可能有助于指导决策和制定个体化治疗方案，但需要更多的大型研究来探索其临床应用。
