Low Geriatric-8 Score as a Potential Risk Factor for Minimally Invasive Surgery in Elderly Patients With Gynecologic Malignancies

Background

The Geriatric-8 (G8) is a validated screening tool for identifying frailty in elderly cancer patients. Although minimally invasive surgery (MIS) is increasingly performed in older adults with gynecologic malignancies, few studies have evaluated the association between G8 scores and perioperative complications in this setting.

Methods

This single-center retrospective study included patients aged ≥ 65 years who underwent MIS for gynecologic malignancies between January 2019 and March 2024. G8 scores were retrospectively calculated using medical records, with a threshold of ≤ 12.5 indicating geriatric risk. Perioperative complications were defined as either (1) Clavien-Dindo classification or CTCAE version 5 grade II or higher within 30 days postoperatively or (2) the need for rehabilitation intervention due to a decline in activities of daily living (ADL). Univariate and multivariate logistic regression analyses were conducted to identify associated factors.

Results

A total of 68 patients were included (median age: 72.5 years). The median G8 score was significantly lower in the complication group than in the non-complication group (12.5 vs. 14.5, p = 0.008). In multivariate analysis, a G8 score ≤ 12.5 was independently associated with perioperative complications (OR: 4.02, 95% CI: 1.38–11.70, p = 0.011). No significant associations were found for operative time, hysterectomy, or lymphadenectomy.

Conclusion

A low G8 score was independently associated with perioperative complications and may be useful for preoperative risk assessment in elderly patients undergoing MIS for gynecologic malignancies.