Published online May 15, 2026. doi: 10.4251/wjgo.v18.i5.116640
Revised: January 20, 2026
Accepted: March 2, 2026
Published online: May 15, 2026
Processing time: 149 Days and 1 Hours
The intensification of global aging has led to an increasing burden of digestive system tumors in the elderly. The comprehensive geriatric assessment (CGA) provides important basis for developing individualized treatment plans by systematically assessing factors such as patient function, nutrition, and comor
To examine the value of the CGA in treatment decision-making and survival prognosis among elderly patients with digestive system tumors.
This retrospective study analyzed the clinical data of 210 elderly patients with digestive system tumors admitted between April 2022 and July 2025. Of these, 108 patients who received traditional diagnostic and therapeutic decisions (April 2022 to December 2023) constituted the control group, whereas 102 patients who received CGA-guided diagnostic and therapeutic decisions (January 2024 to July 2025) comprised the observation group. The initial treatment strategy, intensity, safety, and tolerance, as well as progression-free survival (PFS), were compared between the two groups.
Fewer patients in the observation group received standard treatment and standard-intensity chemotherapy compared with the control group, whereas more received reduced-intensity chemotherapy. The overall incidence of adverse reactions (≥ grade 3) was 28.4% in the observation group, compared with 45.4% in the control group. Treatment delay and discontinuation rates were lower in the observation group (20.6% and 11.8%, respectively) than in the control group (32.4% and 24.1%, respectively). The treatment completion rate was higher in the observation group (88.2%) than in the control group (75.9%). The median PFS was longer in the observation group (11.5 months, 95% confidence interval: 10.2-12.8) than in the control group (9.1 months, 95% confidence interval: 8.0-10.2). All differences were statistically significant (P < 0.05). Multivariate Cox regression analysis showed that a CGA-assessed “frail” status was an independent risk factor affecting patient PFS (P < 0.05).
CGA-guided diagnostic and therapeutic strategies facilitate precise, individualized decision-making for elderly patients with digestive system tumors. By tailoring treatment selection and intensity to overall health status, this approach optimizes the balance between efficacy and safety and is associated with improved PFS, supporting its clinical utility.
Core Tip: Comprehensive geriatric assessment plays a pivotal role in the clinical management of elderly patients with digestive system tumors. By systematically evaluating their physical function, cognitive status, nutritional condition and social support, comprehensive geriatric assessment precisely guides the formulation of personalized treatment regimens. Notably, this evidence-based approach effectively mitigates treatment-related toxicities, enhances patients’ treatment tolerance, and extends their progression-free survival, thus exerting remarkable clinical benefits and practical value in geriatric oncology practice.