Sawada Shiina, Nagamata Satoshi, Yamanaka Keitaro, Masuko Naohisa, Takahashi Ryosuke, Sasagawa Yuuki, Nishimoto Masashi, Wakahashi Sen, Terai Yoshito
Department of Obstetrics and Gynecology, Hyogo Prefectural Harimahimeji General Medical Center, Himeji, Hyogo, Japan.
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70098. doi: 10.1111/ases.70098.
The Geriatric-8 (G8) is a validated screening tool for identifying frailty in elderly cancer patients. Although minimally invasive surgery (MIS) is increasingly performed in older adults with gynecologic malignancies, few studies have evaluated the association between G8 scores and perioperative complications in this setting.
This single-center retrospective study included patients aged ≥ 65 years who underwent MIS for gynecologic malignancies between January 2019 and March 2024. G8 scores were retrospectively calculated using medical records, with a threshold of ≤ 12.5 indicating geriatric risk. Perioperative complications were defined as either (1) Clavien-Dindo classification or CTCAE version 5 grade II or higher within 30 days postoperatively or (2) the need for rehabilitation intervention due to a decline in activities of daily living (ADL). Univariate and multivariate logistic regression analyses were conducted to identify associated factors.
A total of 68 patients were included (median age: 72.5 years). The median G8 score was significantly lower in the complication group than in the non-complication group (12.5 vs. 14.5, p = 0.008). In multivariate analysis, a G8 score ≤ 12.5 was independently associated with perioperative complications (OR: 4.02, 95% CI: 1.38-11.70, p = 0.011). No significant associations were found for operative time, hysterectomy, or lymphadenectomy.
A low G8 score was independently associated with perioperative complications and may be useful for preoperative risk assessment in elderly patients undergoing MIS for gynecologic malignancies.
老年8项评估量表（G8）是一种经过验证的用于识别老年癌症患者虚弱状况的筛查工具。尽管微创手术（MIS）在老年妇科恶性肿瘤患者中越来越普遍，但很少有研究评估在这种情况下G8评分与围手术期并发症之间的关联。
这项单中心回顾性研究纳入了2019年1月至2024年3月期间因妇科恶性肿瘤接受MIS的年龄≥65岁的患者。使用病历回顾性计算G8评分，阈值≤12.5表示老年风险。围手术期并发症定义为：（1）术后30天内根据Clavien-Dindo分类或美国国立综合癌症网络不良事件通用术语标准第5版为II级或更高等级；或（2）因日常生活活动（ADL）能力下降而需要康复干预。进行单因素和多因素逻辑回归分析以确定相关因素。
共纳入68例患者（中位年龄：72.5岁）。并发症组的G8评分中位数显著低于无并发症组（12.5对14.5，p = 0.008）。在多因素分析中，G8评分≤12.5与围手术期并发症独立相关（比值比：4.02，95%置信区间：1.38 - 11.70，p = 0.011）。未发现手术时间、子宫切除术或淋巴结清扫术有显著关联。
低G8评分与围手术期并发症独立相关，可能有助于对接受MIS治疗妇科恶性肿瘤的老年患者进行术前风险评估。
