Perioperative Medicine for Older People Undergoing Surgery (POPS), Guy's & St Thomas' NHS Foundation Trust, London, UK.
Perioperative Medicine for Older People Undergoing Surgery (POPS), Guy's & St Thomas' NHS Foundation Trust, London, UK; Division of Primary Care and Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
J Geriatr Oncol. 2020 Sep;11(7):1087-1095. doi: 10.1016/j.jgo.2020.06.006. Epub 2020 Jun 27.
Older women are increasingly undergoing surgery for gynaecological malignancies. Although survival data is available other outcomes such as functional recovery are less well described. This systematic review and narrative synthesis describes functional recovery after gynaeoncology surgery with respect to baseline characteristics.
Systematic search of MEDLINE and EMBASE databases and Cochrane Library between 1974 to 2018. Two reviewers independently reviewed abstracts/papers for inclusion against the following criteria: Results analysed and presented using narrative synthesis.
Fifteen studies identified (8 Endometrial, 2 Ovarian, 2 Vulval, 3 mixed cancer types). 1/15 used a standalone functional assessment tool, 14/15 used Health-Related Quality of Life tools (EORTC QLQ C30 (8), FACT-G (3), SF-36 (3)) comprising items describing function. More studies showed full recovery to baseline (n = 13) than incomplete recovery (n = 2). Four studies reported a negative association between older age and functional trajectory. Recovery was more likely and occurred faster in minimally-invasive surgery. Few studies reported baseline characteristics including cognition, frailty or comorbidities and none examined associations with functional recovery.
There is inadequate data on functional recovery of older women following gynaeoncology surgery. Future studies are needed to identify factors associated with poorer/better outcomes. This may enable identification of opportunities for risk reduction, improve equity of access and better shared-decision making.
越来越多的老年女性接受妇科恶性肿瘤手术。尽管生存数据可用，但其他结果（如功能恢复）的描述较少。本系统评价和叙述性综合描述了妇科肿瘤手术后的功能恢复情况，重点是基线特征。
系统检索了 MEDLINE 和 EMBASE 数据库以及 Cochrane 图书馆 1974 年至 2018 年的数据。两名审查员独立审查摘要/论文，以确定是否符合以下标准：结果使用叙述性综合进行分析和呈现。
确定了 15 项研究（8 项子宫内膜癌、2 项卵巢癌、2 项外阴癌、3 项混合癌症类型）。1/15 项研究使用了独立的功能评估工具，14/15 项研究使用了健康相关生活质量工具（EORTC QLQ C30（8）、FACT-G（3）、SF-36（3）），其中包含描述功能的项目。更多的研究显示完全恢复到基线（n=13）而不是不完全恢复（n=2）。四项研究报告了年龄较大与功能轨迹之间的负面关联。微创手术后恢复的可能性更大，速度更快。很少有研究报告了基线特征，包括认知、脆弱性或合并症，也没有研究检查这些特征与功能恢复的关系。
妇科肿瘤手术后老年女性功能恢复的数据不足。需要进一步的研究来确定与较差/较好结果相关的因素。这可能有助于确定减少风险的机会，改善获得机会的公平性，并更好地进行共同决策。
