Reliable Prediction of Post-Operative Complications’ Rate Using the G8 Screening Tool: A Prospective Study on Elderly Patients Undergoing Surgery for Kidney Cancer

Abstract

In the last years the incidence of renal neoplasms has been steadily increasing, along with the average age of patients at the time of diagnosis. Surgical management for localized disease is becoming more challenging because of patients’ frailty. We conducted a multi-center prospective study to evaluate the role of the G8 as a screening tool in the assessment of intra and post-operative complications of elderly patients (≥70 y.o.) undergoing surgery for kidney cancer. A total of 162 patients were prospectively enrolled between January 2015 to January 2019 and divided into two study groups (frail vs. not-frail) according to their geriatric risk profile based on G8 score. Several factors (i.e., age, CCI, ASA score, preoperative anemia, RENAL score, surgical procedures, and techniques) were analyzed to identify whether any of them would configure as a statistically significant predictor of surgical complications. According to the G8 Score, 90 patients were included in the frail group. A total of 52 frail patients vs. 4 non-frail patients developed a postoperative complication of any kind (p < 0.001). Of these, 11 were major complications and all occurred in the frail group. Our results suggest that the G8 screening tool is an effective and useful instrument to predict the risk of overall complications in elderly patients prior to renal surgery.

Prognostic factors for overall survival in clinical node‐positive patients with upper tract urothelial carcinoma

“…The importance of geriatric assessment in older cancer patients has been advocated by the International Society of Geriatric Oncology (SIOG) 11 . The clinical utility of G8 scoring has been demonstrated in several cancers as the prediction tool for postoperative complications 9,24 and oncologic outcomes, 8,25 as well as for adverse events after the initiation of systemic therapy 26 . Low BMI, one component of decreased G8 score, has been proven as a prognosticator for worse cancer‐specific survival in UTUC patients who underwent surgery 27 .…”

C-reactive Protein is a Strong Prognostic Factor for Overall Survival in Clinically Node-positive Patients with Upper Tract Urothelial Carcinoma

“…The importance of geriatric assessment in older cancer patients has been advocated by the International Society of Geriatric Oncology (SIOG) [10]. The clinical utility of G8 scoring has been demonstrated in several cancers as the prediction tool for postoperative complications [9,22] and oncologic outcomes [8,23], as well as for adverse events after the initiation of systemic therapy [24]. However, the utility of the G8 tool regarding oncologic outcomes after de nitive surgery in UC patients has still not been validated [25].…”

Geriatrics 8 scores as a predictor of postoperative outcome in elderly patients with Head and Neck cancer in Rajavithi Supertertiary Care Hospital

“…The predictive value of the G8 score for postoperative complication of surgery were waiting for explored. Many studies reported of high accuracy for prediction of postoperative complications in other field of cancer treatment 10-,12 but some reported of impaired G8 not be predictive tool 13. And few reports in Head and Neck cancer surgery.…”