Geriatrik Üroonkolojide Değerlendirme ve Tarama Ölçekleri-Yaşam Kalitesi
Özet
Bu bölümde, geriatrik ürolojik onkoloji hastalarında değerlendirme ve tarama süreçleri bilimsel kanıtlar ve güncel kılavuzlar çerçevesinde analiz edilmektedir. Artan yaşlı nüfusla birlikte prostat, mesane ve böbrek kanseri insidansındaki yükseliş, tarama ve tedavi kararlarının yalnızca kronolojik yaşa değil; yaşam beklentisi, fonksiyonel kapasite, komorbidite yükü ve frailty durumuna dayandırılmasını gerektirmektedir. Bu bağlamda kapsamlı geriatrik değerlendirme (Comprehensive Geriatric Assessment, CGA) temel yaklaşım olarak öne çıkmakta; G8, VES-13, FRAIL ve CARG skorları gibi hızlı tarama araçları klinik pratikte ön eleme amacıyla kullanılmaktadır. Bölümde ayrıca yaşam kalitesi (QoL) kavramının geriatrik üroonkolojiye yansımaları tartışılmakta; EORTC QLQ-C30, FACT-P, EPIC, SF-36 ve WHOQOL-OLD gibi ölçeklerin hasta merkezli bakımda karar süreçlerine entegrasyonu ele alınmaktadır. NCCN, ASCO ve EAU kılavuzlarının karşılaştırmalı değerlendirmesi, tarama ve tedavi planlarının bireyselleştirilmesi gerektiğini göstermektedir. Sonuç olarak geriatrik üroonkoloji, multidisipliner, hasta merkezli ve kanıta dayalı bir yaklaşımı gerektirir; hedef yalnızca sağkalımı artırmak değil, aynı zamanda yaşam kalitesini korumak ve geliştirmektir.
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