Hiltgen Steven Pierre, Bischoff-Ferrari Heike A, Gagesch Michael, Kaltenborn Alexander, Manz Markus G, Rieger Max J, Schwotzer Rahel, Stolz Sebastian M, Zenz Thorsten, Rösler Wiebke
Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland.
Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland.
Front Oncol. 2025 Aug 13;15:1570889. doi: 10.3389/fonc.2025.1570889. eCollection 2025.
INTRODUCTION: The incidence of most cancers increases with age and cancer is a leading cause of morbidity and mortality in the older population. Older cancer patients frequently have additional co-morbidities and functional decline, which can substantially affect treatment outcomes. Major oncology societies recommend a screening for geriatric impairments in patients at risk (e.g. G8), followed by a comprehensive geriatric assessment (CGA). Nevertheless, CGA is often not established in routine care. We describe the implementation process of CGA in patients with hematological cancers at the University Hospital of Zurich. We evaluate its benefits, its perception by physicians and patients, and identify potential obstacles and solutions to allow integration into daily clinical practice. MATERIALS AND METHODS: This retrospective, single-center observational study was conducted at the University Hospital of Zurich. Patients aged ≥65 years with hematological malignancies who underwent CGA within the last 5 years were included. Patients were referred for CGA based on physicians' choice. All data were extracted from electronic medical records and later analyzed. Perception of the CGA by patients and physicians was assessed by a questionnaire. RESULTS: 46 patients who underwent CGA between April 2019 and July 2023 were included in this study. 89.1% showed at least one impaired domain in the CGA. For 98% of patients, one or more interventions were suggested. Low G8 scores were significantly associated with detected CGA-impairments (p<0.05). 70% of patients found the CGA and its resulting recommendations useful and reported benefiting from the process. 75% of the physicians rated the resulting CGA report as helpful for their clinical assessment. CONCLUSION: Our data support the use of a CGA in older patients with hematological cancers based on positive feedback on its implementation, from both patients and treating physicians. Our results emphasize the need for a dedicated geriatric assessment in an older cancer population as it contributes to a more comprehensive medical evaluation and potentially improves overall care and quality of life for patients.
引言：大多数癌症的发病率随年龄增长而上升，癌症是老年人群发病和死亡的主要原因。老年癌症患者常伴有其他合并症和功能衰退，这会严重影响治疗效果。主要肿瘤学会建议对有风险的患者（如G8评分）进行老年功能损害筛查，随后进行全面老年评估（CGA）。然而，CGA在常规医疗中往往未得到落实。我们描述了苏黎世大学医院对血液系统癌症患者实施CGA的过程。我们评估了其益处、医生和患者对它的看法，并确定了将其纳入日常临床实践的潜在障碍和解决方案。 材料与方法：这项回顾性、单中心观察性研究在苏黎世大学医院进行。纳入了过去5年内接受CGA的年龄≥65岁的血液系统恶性肿瘤患者。患者根据医生的选择被转介进行CGA。所有数据均从电子病历中提取并随后进行分析。通过问卷调查评估患者和医生对CGA的看法。 结果：本研究纳入了2019年4月至2023年7月期间接受CGA的46例患者。89.1%的患者在CGA中至少有一个受损领域。98%的患者被建议进行一项或多项干预。低G8评分与检测到的CGA损害显著相关（p<0.05）。70%的患者认为CGA及其产生的建议有用，并报告从该过程中受益。75%的医生认为生成的CGA报告对他们的临床评估有帮助。 结论：基于患者和主治医生对CGA实施的积极反馈，我们的数据支持在老年血液系统癌症患者中使用CGA。我们的结果强调了在老年癌症人群中进行专门老年评估的必要性，因为它有助于更全面的医学评估，并可能改善患者的整体护理和生活质量。
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