Articol susținut de S.N.O.M.R.

Radu Vidra 1,2,3 , Paula-Viorica Alexander 4,* and Gabor Liposits 5

1. MEDFUTURE Biomedical Research Institute, Department of Personalized Medicine and Rare Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania; radu.vidra@irgh.ro
2. Department of Medical Oncology, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
3. UBBMed, The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babes-Bolyai University, 400347 Cluj-Napoca, Romania
4. Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj-Napoca, Romania
5. Department of Oncology, San Maurizio Central Hospital in Bolzano, South Tyrolean Health Service, 39100 Bolzano, BZ, Italy
* Correspondence: alexanderpaula88@yahoo.com

J. Clin. Med. 2025, 14(23),8448

DOI: https://doi.org/10.3390/jcm14238448

Abstract:
The global burden of gastrointestinal (GI) cancers is rising sharply among the elderly, with a projected doubling of incidence and mortality by 2050. Given the heterogeneity of aging and the limitations of traditional performance scales such as ECOG or KPS, integrating geriatric assessment (GA) into oncology has become essential for tailoring safe and effective treatment strategies in this population. This paper provides a practical framework for implementing geriatric assessment and management (GAM) in GI oncology, particularly in resource-limited settings, and highlights validated screening instruments suitable for clinical integration.
Methods:
A systematic search was performed across PubMed, Scopus, and Web of Science databases for publications between January 2019 and August 2025 using combinations of the keywords geriatric assessment, gastrointestinal cancer, frailty screening, elderly, oncology, and comprehensive geriatric assessment. International and regional clinical practice guidelines from ASCO, ESMO, and SIOG were reviewed in detail. Articles were included when they addressed validated screening tools, oncology focused strategies, or clinical outcomes associated with GA-based interventions. Studies focusing exclusively on non-oncologic geriatric populations were excluded. Relevant data were extracted regarding study design, population, tool validation, predictive performance, and feasibility.
Results:
A systematic search was performed across PubMed, Scopus, and Web of Science databases for publications between January 2019 and August 2025 using combinations of the keywords geriatric assessment, gastrointestinal cancer, frailty screening, elderly, oncology, and comprehensive geriatric assessment. International and regional clinical practice guidelines from ASCO, ESMO, and SIOG were reviewed in detail. Articles were included when they addressed validated screening tools, oncology focused strategies, or clinical outcomes associated with GA-based interventions. Studies focusing exclusively on non-oncologic geriatric populations were excluded. Relevant data were extracted regarding study design, population, tool validation, predictive performance, and feasibility. Results: GA improves prediction of treatmentrelated toxicity, supports individualized treatment planning, and enhances quality of life and functional outcomes. Two-step screening approaches, initial frailty screening followed by comprehensive geriatric assessment for those with positive results, were found most effective. Practical GA models and telehealth-based applications were identified as feasible even in low- and middle-income contexts.
Conclusions:
Integrating GA into GI oncology fosters patient-centered, evidence-based care that optimizes treatment tolerance, reduces complications, and aligns therapeutic goals with patient values. Institutional commitment, interdisciplinary collaboration, and targeted training are pivotal for establishing GA as a standard of care across diverse healthcare settings.