Shimaoka Hideki, Yoshida Yoichiro, Yamada Teppei, Shimokoube Hisaaki, Aisu Naoya, Ogawa Shinichiro, Tamura Kazuo, Hasegawa Suguru
Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan.
Department of Medical Informatics and Digital Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan.
Int J Clin Oncol. 2025 Mar;30(3):457-468. doi: 10.1007/s10147-024-02688-9. Epub 2025 Jan 7.
Population aging and increased cancer incidence have made the treatment of cancer in older individuals an increasingly important issue. Geriatric 8 (G8) is a screening tool developed to identify patients who would benefit most from a comprehensive geriatric assessment (GA). Previous G8 studies have involved older patients, but the age-related significance and usefulness of G8 is unknown. In this study, G8 screening was administered to patients who were 30 years of age or over with cancer to examine a G8 score in each 10 years age group and its correlation with other GA tools.
The study was conducted at Fukuoka University Hospital from January 2020 to March 2022 and enrolled 715 patients aged ≥ 30 years undergoing surgery for primary gastrointestinal cancer or malignant disease. The relationship between age, G8, instrumental activities of daily living (IADL), activities of daily living (ADL), and the Charlson Comorbidity Index (CCI) was investigated.
The median age of the patients was 69 years (34-98 years). Functional disability in ADLs was present in 43 patients (6%) and in IADLs in 72 patients (10.1%). The mean G8 score by age group was 13.7, 13.1, 13.3, 13.3, 12.4, 11.3, and 9.25 for ages 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, and 90-100 years, respectively. For each of the ADL/IADL items, the group with functional disability had significantly lower G8 scores than the group without functional disability (p < 0.001). The relationship between the G8 score and CCI by age group showed that the G8 score decreased as the CCI score increased. Assessments divided into age groups of 65, 70, and 75 years showed significant differences between groups for most ADL/IADL items and G8 scores, even when divided by age 65.
G8 scores were lower in patients with ADL/IADL disabilities and decreased with age in both the presence and absence of disabilities. The G8 total score decreased significantly after the age of 70 years. Performing G8 in patients < 65 years of age does not decrease sensitivity; however, the functional decline is so slight that it appears reasonable to restrict G8 screening to patients ≥ 65 years of age.
人口老龄化和癌症发病率上升使得老年个体的癌症治疗成为一个日益重要的问题。老年8项(G8)是一种筛查工具,旨在识别能从全面老年评估(GA)中获益最大的患者。以往的G8研究涉及老年患者,但G8与年龄相关的意义和实用性尚不清楚。在本研究中,对30岁及以上的癌症患者进行G8筛查,以检查每10岁年龄组的G8评分及其与其他GA工具的相关性。
本研究于2020年1月至2022年3月在福冈大学医院进行,纳入715例年龄≥30岁、因原发性胃肠道癌或恶性疾病接受手术的患者。研究了年龄、G8、日常生活工具性活动(IADL)、日常生活活动(ADL)和Charlson合并症指数(CCI)之间的关系。
患者的中位年龄为69岁(34 - 98岁)。43例患者(6%)存在ADL功能障碍,72例患者(10.1%)存在IADL功能障碍。按年龄组划分,30 - 39岁、40 - 49岁、50 - 59岁、60 - 69岁、70 - 79岁、80 - 89岁和90 - 100岁年龄组的G8平均评分分别为13.7、13.1、13.3、13.3、12.4、11.3和9.25。对于每个ADL/IADL项目,有功能障碍的组G8评分显著低于无功能障碍的组(p < 0.001)。按年龄组划分的G8评分与CCI之间的关系表明,随着CCI评分增加,G8评分降低。按65岁、70岁和75岁年龄组进行评估显示,即使按65岁划分,大多数ADL/IADL项目和G8评分在组间也存在显著差异。
ADL/IADL功能障碍患者G8评分较低,无论有无功能障碍,G8评分均随年龄增长而降低。70岁以后G8总分显著下降。对<65岁的患者进行G8评估不会降低敏感性;然而,功能下降非常轻微,因此将G8筛查限制在≥65岁的患者似乎是合理的。