Levassort H, Pépin M, Teillet L, Ghebriou D, Cudennec T
Service de médecine gériatrique, AP-HP, Université Paris-Saclay site Ambroise-Paré, 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
Service de médecine gériatrique, AP-HP, Université Paris-Saclay site Ambroise-Paré, 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Université Paris Saclay, UVSQ, INSERM, CESP, Equipe épidémiologie clinique, 92100 Boulogne-Billancourt, France.
Rev Med Interne. 2022 Mar;43(3):152-159. doi: 10.1016/j.revmed.2021.10.006. Epub 2021 Nov 23.
With aging worldwide population and the high incidence of cancer in the population of people over 75 years old, there is a need for oncologists and geriatricians to strengthen their collaboration to improve elderly patients care. Complexity of cancer and aging issues must be considered simultaneously to establish a personalized care plan. Thus, the G8 is a screening tool that allows to identify patients who should benefit from a geriatric assessment, which is a key step in the management process. This specific evaluation offers a multidisciplinary approach to functional, psychological, nutritional, cognitive and social status and has demonstrated its prognostic value in terms of choice of treatment but also in terms of patient survival. In nearly 20% of cases, the geriatric assessment leads to a change in the choice of treatment, and at one year the initial care plan is not carried out in a quarter of cases. The presence of malnutrition and functional impairment leading to dependence on basic activities of daily living had a significant impact on this change in therapeutic choice. Survival is not only impacted by malnutrition and functional impairment but also by the presence of severe comorbidities and thymic and neurocognitive impairment. The patient's choice must remain at the center of the elaboration of the care plan with the oncologists and geriatricians in order to propose the most appropriate treatment for his or her situation.
随着全球人口老龄化以及75岁以上人群中癌症的高发病率，肿瘤学家和老年病学家需要加强合作以改善老年患者的护理。必须同时考虑癌症和衰老问题的复杂性，以制定个性化的护理计划。因此，老年综合评估（G8）是一种筛查工具，可用于识别那些应从老年综合评估中受益的患者，而老年综合评估是管理过程中的关键一步。这种特定评估提供了一种针对功能、心理、营养、认知和社会状况的多学科方法，并且已在治疗选择方面以及患者生存方面证明了其预后价值。在近20%的病例中，老年综合评估会导致治疗选择的改变，并且在一年后，四分之一的病例未执行初始护理计划。营养不良和功能障碍导致对日常生活基本活动的依赖，对这种治疗选择的改变有重大影响。生存不仅受到营养不良和功能障碍的影响，还受到严重合并症以及胸腺和神经认知障碍的影响。在制定护理计划时，患者的选择必须始终处于肿瘤学家和老年病学家工作的中心，以便为其情况提出最合适的治疗方案。
