Department of Urology, National Cancer Center Hospital East, Chiba, Japan.
Int J Urol. 2024 Jun;31(6):607-615. doi: 10.1111/iju.15432. Epub 2024 Feb 25.
In urologic oncology, which often involves older patients, it is important to consider how to manage their care appropriately. Geriatric assessment (GA) is a method that can address the specific needs of older cancer patients. The GA encompasses various assessment domains, but these domains exhibit variations across the literature. Some of the common items include functional ability, nutrition, comorbidities, cognitive ability, psychosocial disorders, polypharmacy, social and financial support, falls/imbalance, and vision/hearing. Despite the diversity of domains, there is limited consensus on reliable measurement methods. This review discusses the role of GA in managing urologic cancer in unique scenarios, such as those necessitating temporary or permanent urinary catheters or stomas due to urinary diversion. A comprehensive GA is time and human-resource-intensive in real-world clinical practice. Hence, simpler tools such as the Geriatric-8 (G8), capable of identifying high-risk patients requiring a detailed GA, are also under investigation in various contexts. Therefore, we conducted a systematic literature review on the G8. Our findings indicate that patients with low G8 scores encounter difficulties with stoma self-care after urinary diversion and have higher risks of urinary tract infections and ileus after radical cystectomy. The utilization of G8 as a screening tool for urologic cancer patients may facilitate the delivery of appropriate and personalized treatment and care.
在泌尿科肿瘤学中,经常涉及老年患者,因此重要的是要考虑如何妥善管理他们的护理。老年评估(GA)是一种可以满足老年癌症患者特定需求的方法。GA 涵盖了各种评估领域,但这些领域在文献中存在差异。一些常见的项目包括功能能力、营养、合并症、认知能力、心理社会障碍、多种药物治疗、社会和经济支持、跌倒/平衡问题以及视力/听力。尽管领域多样,但在可靠的测量方法上仍存在有限的共识。这篇综述讨论了 GA 在管理泌尿科癌症方面的作用,这些癌症在特殊情况下需要临时或永久的导尿管或造口术,例如由于尿路分流术导致的情况。在现实临床实践中,全面的 GA 既耗时又需要大量人力资源。因此,一些更简单的工具,如能够识别需要详细 GA 的高风险患者的老年-8 项评分(G8),也正在各种情况下进行研究。因此,我们对 G8 进行了系统的文献综述。我们的研究结果表明,G8 评分较低的患者在尿路分流术后进行造口自我护理时会遇到困难,并且在根治性膀胱切除术后发生尿路感染和肠梗阻的风险更高。将 G8 用作泌尿科癌症患者的筛查工具可能有助于提供适当和个性化的治疗和护理。