スギモト　ケン   Ken Sugimoto   杉本　研    所属   川崎医科大学  医学部 臨床医学　総合老年医学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Development of a Geriatric Prognostic Scoring System for Predicting Survival After Surgery for Elderly Patients With Gastrointestinal Cancer
掲載誌名	正式名：Annals of surgical oncology 略　 称：Ann Surg Oncol ISSNコード：15344681/10689265
掲載区分	国外
巻・号・頁	26(11),pp.3644-3651
著者・共著者	Yamasaki Makoto, Maekawa Yoshihiro, Sugimoto Ken, Mizushima Tsunekazu, Eguchi Hidetoshi, Ogihara Toshio, Shintani Ayumi, Rakugi Hiromi, Mori Masaki, Doki Yuichiro
発行年月	2019/10
概要	BACKGROUND:The number of elderly patients with gastrointestinal cancer is rising as the population ages. This study aimed to assess the impact of a preoperative geriatric assessment on postoperative survival and to develop a geriatric prognostic scoring system (GPSS) for elderly patients.METHODS:Patients (n = 544) age 75 years or older who had undergone radical surgery for gastrointestinal cancer were recruited for this observational study. Geriatric assessments (GAs) using the Barthel Index, the Mini-Mental State Examination, Instrumental Activities of Daily Living, the Vitality Index, and the Geriatric Depression Score were administered before surgery. Multivariable analysis was performed using a Cox proportional hazard regression model to identify significant prognostic factors. The GPSS was developed using regression coefficients of the multivariable regression to predict overall survival (OS). Thereafter, 165 consecutive patients were prospectively validated to test the authors' model.RESULTS:The independent predictors of OS appeared to be GA as well as age, type of cancer, clinical stage, performance status, and body mass index. The patients were classified into high- and low-risk groups according to the GPSS. The overall 3-year survival was 79% in the low-risk group and 26% in the high-risk group (hazard ratio [HR], 5.69; 95% confidence interval [CI] 4.35-7.42; p < 0.0001). Furthermore, when GPSS was applied to independent cohorts, the patients in the high-risk group showed significantly poorer prognoses than those in the low-risk group (HR, 4.49; 95% CI 2.65-7.60; p < 0.0001).CONCLUSIONS:Geriatric assessments were closely associated with postoperative OS. The GPSS is useful in predicting postoperative prognosis and may help determine treatment strategies for elderly patients with gastrointestinal cancer.
DOI	10.1245/s10434-019-07687-z
PMID	31388777