Geriatric 8 Score Predicts Functional Decline After Endoscopic Resection for Upper Gastrointestinal Neoplasms in Older Adults: A Prospective Cohort Study.

Objectives: Endoscopic resection (ER) is used in older patients to treat upper gastrointestinal (UGI) neoplasms due to minimal invasiveness and excellent short-term therapeutic outcomes. However, its impact on functional outcomes remains unclear. This study aimed to identify functional-decline predictors post-ER in older patients. Methods: This prospective, single-center cohort study included patients aged ≥75 years undergoing ER for UGI neoplasms between April 2017 and December 2021. Cognitive and physical functions were assessed using the Mini-Mental State Examination (MMSE) and Instrumental Activities of Daily Living (IADL) scales, before and 6-9 months post-ER. Functional decline was defined as a decrease of ≥3 points in MMSE or ≥1 point in IADL. Scores of geriatric assessment tools, including the Geriatric 8 (G8), Vulnerable Elders Survey-13 (VES-13), Flemish Triage Risk Screening Tool, and Mini-Cognitive Assessment Instrument (Mini-Cog), were evaluated as potential functional-decline predictors. Results: Of 202 patients, 37 (18.3%) experienced functional decline post-ER. In multivariate analysis, poor G8 scores (≤14) were independent risk factors for functional decline (odds ratio: 2.64, 95% confidence interval: 1.02-6.84, p = 0.0461). Functional-decline incidence gradually increased as G8 scores decreased (p = 0.0086, trend test). Conclusions: Preoperative G8 scores may serve as functional-decline predictors in older patients undergoing ER for UGI neoplasms. A preoperative G8 assessment could facilitate risk-based treatment decisions from the perspective of functional outcomes in this vulnerable population.