Geriatric 8 score predicts surgical risk and oncologic outcomes in older patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy.

Authors

Chien-Hsiung Lo, Cheng-Han Chang, Che-Yuan Hu, Yin-Chien Ou, Kun-Che Lin, Yuh-Shyan Tsai, Hau-Chern Jan, Kuan-Yu Wu

Published in

BMC geriatrics. Jul 07, 2026. Epub Jul 07, 2026.

Abstract

Accurate preoperative risk stratification remains challenging in older patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). This study evaluated whether preoperative Geriatric 8 (G8) score is associated with perioperative and oncologic outcomes.
We retrospectively analyzed 338 patients aged ≥ 65 years who underwent RNU between 2013 and 2022. Patients were classified as G8-low (score ≤ 14) or G8-high (score > 14). Multivariable logistic and Cox regression analyses assessed the association between frailty, postoperative complications (Clavien-Dindo classification), and survival outcomes, including overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS).
Overall, 178 patients (52.7%) were G8-low. G8-low patients exhibited significantly longer hospital stays and higher rates of minor (Clavien I-II: 60.1% vs. 35.6%, p < 0.001) and major complications (Clavien III-V: 12.4% vs. 3.7%, p = 0.004). Multivariable analysis identified G8-low as an independent predictor of postoperative complications (OR 2.51; 95% CI 1.50-4.20; p < 0.001), demonstrating superior prognostic value compared to ASA classification. Furthermore, G8-low remained an independent predictor of worse OS (HR 1.76, 95% CI 1.17-2.65; p = 0.006), CSS (HR 2.00, 95% CI 1.31-3.07; p = 0.001), and PFS (HR 1.73, 95% CI 1.20-2.50; p = 0.004).
Preoperative G8-low status, is independently associated with increased postoperative complications and poorer oncologic outcomes in older UTUC patients undergoing RNU. Incorporating G8 screening into routine preoperative evaluation may facilitate accurate risk stratification, aiding shared decision-making regarding radical versus nephron-sparing approaches.

PMID:
42410388
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.