Department of Obstetrics and Gynecology, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Department of Preventive Medicine and Public Health, Fukuoka University, 7-45-1 Nanakuma, Jhonan-ku, Fukuoka, Fukuoka, Japan.
Sci Rep. 2021 Nov 23;11(1):22789. doi: 10.1038/s41598-021-02319-7.
Elderly cancer patients requiring surgical treatment are increasing, and the deterioration of quality of life and shortening of healthy life expectancy due to postoperative complications represent major problems. This study investigated the current status of medical treatment, including perioperative evaluations, for elderly cancer patients requiring surgical treatment at cancer treatment facilities nationwide. A total of 436 cancer care facilities around Japan were invited to participate in this web-based survey regarding management of cancer patients ≥ 65 years old who had undergone surgical treatment in 2018. A total of 919 department heads from 245 facilities agreed to participate. Although most respondents answered that performance status, preoperative examinations, and comorbidities were important when deciding on a treatment plan, age, Geriatric Assessment (GA), and guidelines were "not important" for > 10% of all respondents. GA was familiar to 195 department heads (21%), and awareness of GA was significantly lower among respondents from medical education institutions than the other types of hospitals (18.5% vs 26.3%; P = 0.006). This large survey revealed that the use of GA is not widespread, and its awareness in medical education institutions remains low. We believe that accumulating evidence of geriatric oncology surgery is an urgent issue in Japan.
需要接受手术治疗的老年癌症患者正在增加，术后并发症导致的生活质量恶化和健康预期寿命缩短是主要问题。本研究调查了全国癌症治疗机构中需要接受手术治疗的老年癌症患者的医疗现状，包括围手术期评估。日本各地共有 436 家癌症护理机构受邀参与了这项针对 2018 年接受过手术治疗的≥65 岁癌症患者管理的网络调查。共有 245 家机构的 919 个科室主任表示同意参与。尽管大多数受访者回答说，在决定治疗方案时，体能状态、术前检查和合并症很重要，但对于所有受访者的>10%，年龄、老年综合评估（GA）和指南“不重要”。有 195 个科室主任（21%）熟悉 GA，而与其他类型的医院相比，医学教育机构的 GA 意识较低（18.5%对 26.3%；P=0.006）。这项大型调查显示，GA 的使用并不广泛，医学教育机构的 GA 意识仍然较低。我们认为，积累老年肿瘤外科学的证据是日本的一个紧迫问题。
