Flethe C, Krause C, von Beckerath A, Alavi-Demirci S, Kolb G, Beck M, Pietzner K, Sehouli J
Young Academy of Gynecologic Oncology (JAGO), North-Eastern German Society of Gynecologic Oncology (NOGGO), Berlin, Germany.
Department of Gynecology, Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität Zu Berlin, Berlin Institute of Health, Berlin, Germany.
Arch Gynecol Obstet. 2025 Oct;312(4):1337-1344. doi: 10.1007/s00404-025-08129-w. Epub 2025 Jul 31.
The global aging trend is expected to double the population aged 65 and older by 2050, posing new challenges for healthcare systems. Frailty is associated with poorer prognosis, increased postoperative complications, and reduced treatment tolerance. Accurate frailty assessment (FA) is therefore crucial for diagnosis, risk stratification, and individualized treatment planning. Despite its clinical relevance, clear evidence-based guidance for implementation in gynecologic oncology remains lacking.
An anonymous online survey with 51 multiple-choice and open-ended questions was conducted from May to August 2022. It targeted gynecologists and oncologists in Germany, Austria, and Switzerland, and was distributed to 633 healthcare institutions.
A total of 112 responses were analyzed, revealing considerable variation in the application of frailty assessments. Only 11% reported routine use, while 36% applied FA selectively. Screening tools varied: 52% used institution-specific forms, while validated instruments such as G8 or VES-13 were rarely used. Timing was inconsistent: 49% performed FA preoperatively, 36% before chemotherapy, 31% at first presentation, and 30% without a fixed timepoint. Prehabilitation programs were largely absent; only 21% of institutions offered them. 77% of respondents indicated a need for further training.
There are substantial gaps in the use of frailty assessments in gynecologic oncology. Standardized procedures, prehabilitation programs, and targeted education are essential to improve care quality and treatment outcomes in the context of an aging patient population.
预计到2050年，全球老龄化趋势将使65岁及以上人口数量翻倍，给医疗系统带来新挑战。衰弱与较差的预后、术后并发症增加以及治疗耐受性降低相关。因此，准确的衰弱评估对于诊断、风险分层和个体化治疗规划至关重要。尽管其具有临床相关性，但在妇科肿瘤学中实施的明确循证指南仍然缺乏。
2022年5月至8月进行了一项包含51个选择题和开放式问题的匿名在线调查。调查对象为德国、奥地利和瑞士的妇科医生和肿瘤学家，并分发给633个医疗机构。
共分析了112份回复，结果显示衰弱评估的应用存在很大差异。只有11%报告常规使用，而36%选择性地应用衰弱评估。筛查工具各不相同：52%使用机构特定表格，而很少使用G8或VES - 13等经过验证的工具。评估时间不一致：49%在术前进行衰弱评估，36%在化疗前，31%在初次就诊时，30%没有固定时间点。术前康复计划基本不存在；只有21%的机构提供此类计划。77%的受访者表示需要进一步培训。
妇科肿瘤学中衰弱评估的使用存在重大差距。标准化程序、术前康复计划和针对性教育对于在老年患者群体背景下提高护理质量和治疗效果至关重要。
