TABLE 3.

Major studies on geriatric assessment and perioperative outcomes in hepatobiliary‐pancreatic cancers

Author (year)	Study cohort	Geriatric assessment tool/cut‐off value (% of frail patients)	Postoperative complications	Postoperative mortality	Length of hospital stay	Patient survival
HCC
Ishihara et al (2021)	HCC Age: ≥65 years n = 295 Hepatic resection	Kihon Checklist Score ≥6 (n = 127, 43%)	↑ (Postoperative delirium, 15% vs 1.8%, P < 0.001)	–	–	–
Kaibori et al (2021)	HCC Age: ≥70 years n = 100 Hepatic resection	Geriatric‐8 The reduction in G8 score at six months (n = 30, 30%)	NS	–	–	↓ OS: HR 8.1 (95%CI, 4.0‐16.3) RFS: HR 5.4 (95%CI, 3.2‐9.0)
Yamada et al (2021)	HCC Age: ≥75 years n = 92 Hepatic resection	Clinical Frailty Scale Score ≥4 (n = 21, 23%)	NS	NS	NS	↓ CSS: HR 7.9 (95%CI, 1.6‐38.1)
Tanaka et al (2018)	HCC Age: ≥65 years n = 217 Hepatic resection	Kihon Checklist Score ≥8 (n = 63, 29%)	↑ (Bile leakage, 11% vs 3.2%, P = 0.021; delirium, 13% vs 1.9%, P = 0.003)	↑ (90‐day mortality, 4.8% vs 0%, P = 0.024)	‐	‐
Kaibori et al (2016)	HCC Age: ≥70 years n = 71 Hepatic resection	Geriatric‐8 Score <14 (n = 39, 55%)	↑ (CD ≥II, 44% vs 3%, P < 0.001)	NS	↑ (Postoperative hospital stay ≥13 days, 67% vs 38%, P = 0.014)	‐
Pancreatic cancer
Mima et al (2021)	Pancreatic cancer Age: ≥18 years n = 142 Elective resection	Clinical Frailty Scale Score ≥5 (n = 16, 11%)	NS	NS	–	↓ OS: HR 2.3 (95%CI, 1.1‐4.4) CSS: HR 2.5 (95%CI, 1.1‐5.3)
Ngo‐Huang et al (2019)	Pancreatic ductal adenocarcinoma Age: ≥18 years n = 47 Elective resection	Fried Frailty Criteria Frail: n = 7, 15%	–	–	–	↓ (P = 0.038)
Mogal et al (2017)	Pancreatic cancer n = 9986 Elective PD	Modified frailty index Score/11 ≥ 0.27 (n = 637, 6.4%)	↑ (CD III/IV, 41% vs 29%, P < 0.001)	↑ (6.3% vs 2.7%, P < 0.001)	‐	‐
Augustin et al (2016)	Pancreatic cancer Age: ≥18 years n = 13 020 Elective PD or DP	Modified frailty index Score ≥5 (n = 45, 0.4%)	↑ (CD IV, PD: 37% vs 7.1%, P < 0.001; DP, 28% vs 3.4%, P < 0.001)	↑ (PD, 22% vs 1.6%, P < 0.001; DP, 11% vs 0.6%, P < 0.001)	↑ (PD, 20 days vs 13 days, P < 0.001; DP, 17 days vs 8 days, P < 0.001)	‐
Dale et al (2014)	Pancreatic tumors Age: ≥18 years n = 76 Elective PD	Fried Frailty Criteria “Self‐reported Exhaustion” (n = 28, 37%)	↑ (CD ≥III, OR, 4.1, P = 0.01)	–	↑ (P = 0.02)	‐

Note: ↑, higher incidence of postoperative complications or mortality, and longer length of hospital stay in frail patients; ↓, shorter overall, cancer‐specific, or recurrence‐free survival in frail patients; −, not examined.

Abbreviations: CD, Clavien‐Dindo grade; CI, confidence interval; CSS, cancer‐specific survival; DP, distal pancreatectomy; HCC, hepatocellular carcinoma; HR, hazard ratio; NS, not significant (P > 0.05); OS, overall survival; PD, pancreaticoduodenectomy.