Clinical utility of geriatric assessment for older surgical patients with gastrointestinal cancer: Evidence, gaps and future directions.

As the global population ages, the number of older adults undergoing surgery for gastrointestinal cancer continues to increase. Although advances in surgical techniques have expanded treatment options for older patients with gastrointestinal cancer, age-related vulnerability and heterogeneity in functional reserve pose substantial challenges to surgical decision-making. Geriatric assessment (GA) is a multidimensional evaluation designed to identify vulnerabilities that are not captured by conventional surgical risk assessments. While GA has been widely recommended in medical oncology, its role in surgical oncology has not been comprehensively elucidated. We conducted a structured narrative review to clarify the applicability of GA and GA-guided management (GAM) in older surgical patients with gastrointestinal cancer. Existing studies suggest that GA may be useful for identifying previously unrecognized vulnerabilities, thereby supporting surgical and perioperative decision-making. Selected studies indicate potential benefits of GAM in reducing postoperative complications and geriatric syndromes. Further prospective studies focusing on patient-centered outcomes are warranted for broader implementation of GA and GAM.