Abstract:
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.
摘要:
在泌尿外科肿瘤中,通常涉及老年患者,重要的是要考虑如何适当地管理他们的护理。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涵盖各种评估领域,但是这些领域在文献中表现出差异。一些常见的项目包括功能能力,营养,合并症,认知能力,社会心理障碍,多药,社会和财政支持,跌倒/不平衡,视觉/听觉。尽管领域的多样性,关于可靠的测量方法的共识有限。这篇综述讨论了GA在独特情况下管理泌尿系癌症的作用,例如由于尿流改道而需要临时或永久性导尿管或造口的那些。在现实世界的临床实践中,全面的GA是时间和人力资源密集型的。因此,更简单的工具,如老年8号(G8),能够识别需要详细GA的高风险患者,也在各种情况下进行调查。因此,我们对八国集团进行了系统的文献综述。我们的发现表明,G8评分较低的患者在尿流改道后会遇到造口自我护理困难,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。使用G8作为泌尿系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。