Comparison of retroperitoneal laparoscopic radical nephroureterectomy outcomes in elderly patients based on the Geriatric 8 (G8) screening tool.

Abstract

Aim: The Geriatric 8 (G8) screening tool consists of eight questions and is widely used to assess geriatric frailty. This study aimed to compare laparoscopic radical nephroureterectomy outcomes in patients aged >70 years with high and low G8 scores.

Materials and methods: Patients who underwent laparoscopic radical nephroureterectomy at a single center between 2017 and 2022 were included in this study. Patient background and perioperative outcomes were evaluated in two groups: low G8 (<14) and high G8 (≥14). The effects of age and body mass index (BMI) were assessed using logistic regression models adjusted for inverse-probability treatment weighting in the low G8 and high G8, respectively.

Results: In total, 37 cases were categorized as low G8 and 30 cases as high G8. Significant differences in patient background were found in terms of age, BMI, American Society of Anesthesiologists physical status, presence of dementia, and estimated glomerular filtration rate (eGFR). Significant differences in perioperative outcomes were observed in the operative time and number of lymph node dissections. Postoperative delirium and eGFR were significantly higher in the low G8 group. The high G8 group showed significantly higher recurrence-free survival and overall survival rates than the low G8 group. After adjustment using the inverse-probability treatment weighting method, postoperative delirium and eGFR were significantly higher in the low G8 group but there were no significant differences in recurrence-free survival rates, cancer-specific survival, or overall survival.

Conclusion: After adjusting for age and BMI, preoperative G8 had a different frequency of postoperative delirium but had no effect on prognosis. Geriatr Gerontol Int 2025; ••: ••-••.