ABSTRACT
OBJECTIVE: To examine the association between the outcomes of a pre-operative comprehensive geriatric assessment (CGA) and the risk of severe post-operative complications in elderly patients electively operated for colorectal cancer. METHODS: One hundred seventy-eight consecutive patients ≥ 70 years electively operated for all stages of colorectal cancer were prospectively examined. A pre-operative CGA was performed, and patients were categorized as fit, intermediate, or frail. The main outcome measure was severe complications within 30 days of surgery. RESULTS: Twenty-one patients (12%) were categorized as fit, 81 (46%) as intermediate, and 76 (43%) as frail. Eighty-three patients experienced severe complications, including three deaths; 7/21 (33%) of fit patients, 29/81 (36%) of intermediate patients and 47/76 (62%) of frail patients (p=0.002). Increasing age and ASA classification were not associated with complications in this series. CONCLUSION: CGA can identify frail patients who have a significantly increased risk of severe complications after elective surgery for colorectal cancer.
Subject(s)
Colorectal Neoplasms/surgery , Elective Surgical Procedures/adverse effects , Geriatric Assessment , Postoperative Complications/diagnosis , Aged , Aged, 80 and over , Cohort Studies , Colorectal Neoplasms/therapy , Female , Humans , Male , Prospective Studies , Treatment OutcomeABSTRACT
Surgeons have always dealt with elderly cancer patients, but understanding frailty and tailoring treatment is a new achievement endeavour. Mounting evidence is resulting in the introduction of geriatric assessment into clinical practice. Particularly, undernourishment should be assessed and corrected in order to avoid emergency situations whenever possible.
