Horiuchi Kohei, Kuno Toshiki, Takagi Hisato, Egorova Natalia N, Afezolli Debora
Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA.
Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
J Geriatr Oncol. 2024 Apr;15(3):101656. doi: 10.1016/j.jgo.2023.101656. Epub 2023 Nov 7.
Older adults with cancer who are being considered for cancer surgery are heterogenous, with variation in their physical, mental, and social baselines and risk of postoperative complications. Due in part to the complex nature of this population, the optimal preoperative evaluation method is not clearly defined. In this study we investigated whether geriatric-8 (G8), a screening tool for older patients with cancer that determines the need for a full geriatric assessment, is suitable for assessing the risk of postoperative complications in this population being considered for surgery.
Studies that enrolled older patients undergoing cancer surgery and compared prevalence of postoperative complications in G8 "high" (≥15) patients and G8 "low" (<15) patients were identified using PubMed and EMBASE. A meta-analysis was conducted to calculate the risk ratio of postoperative complication rate. Postoperative mortality was systematically reviewed.
Eleven studies published between 2017 and 2022 were included in our analysis with a total of 2,691 older patients who underwent various types of cancer surgery and were characterized by their G8 scores: 1,255 G8 high (≥15) patients and 1,436 G8 low (<15) patients. G8 low patients had a significantly higher prevalence of postoperative complications than G8 high patients (risk ratio [95% confidence interval]: 1.56 [1.18-2.07], p = 0.002, I = 79%).
G8 can be an effective and efficient preoperative tool to assess risk of postoperative complications in older adults undergoing cancer surgery and identify potential need for further evaluation of an individual's risk with a comprehensive geriatric assessment.
考虑接受癌症手术的老年癌症患者具有异质性，其身体、心理和社会基线以及术后并发症风险存在差异。部分由于该人群的复杂性，最佳的术前评估方法尚未明确界定。在本研究中，我们调查了老年8项（G8）评估工具，这是一种用于评估老年癌症患者是否需要进行全面老年评估的筛查工具，是否适用于评估该手术人群的术后并发症风险。
通过PubMed和EMBASE检索纳入老年癌症手术患者并比较G8“高风险”（≥15分）患者和G8“低风险”（<15分）患者术后并发症发生率的研究。进行荟萃分析以计算术后并发症发生率的风险比。对术后死亡率进行系统综述。
我们的分析纳入了2017年至2022年间发表的11项研究，共有2691例接受各种类型癌症手术的老年患者，根据G8评分进行分类：1255例G8高风险（≥15分）患者和1436例G8低风险（<15分）患者。G8低风险患者术后并发症的发生率显著高于G8高风险患者（风险比[95%置信区间]：1.56[1.18 - 2.07]，p = 0.002，I² = 79%）。
G8可以作为一种有效且高效的术前工具，用于评估接受癌症手术的老年患者的术后并发症风险，并通过全面老年评估确定个体风险进一步评估的潜在需求。
