Definition and assessment of frailty in older patients: the surgical, anaesthesiological and oncological perspective

Abstract

The number of oncology, surgery and anaesthesia procedures in older patients has greatly increased in recent years due to ageing populations. Older patients are typically characterised by physical changes such as comorbidities, decline in physiological activities and cognitive impairment. All these factors, together with polypharmacological therapies, may substantially impact perioperative outcome, quality of recovery and, more in general, quality of life. A comprehensive multidisciplinary approach to perioperative care is thus needed. The assessment of frailty has a central role in the pre-operative evaluation of older patients and, with a multidisciplinary approach. The best surgical procedures and oncologic therapies can be accurately discussed in the pre-and post-operative periods. All clinicians involved in this scenario should be proactive in multidisciplinary care to achieve better outcomes.

Thoracoscopic pulmonary metastasectomy in metastatic colorectal cancer: Surgical outcomes and prognostic factors

“…Sponholz et al claimed that morbidity, mortality, and overall survival after pulmonary metastasectomy with lymphadenectomy in older patients were comparable to those in younger patients 15 . Generally, the older or elderly population is defined as those ≥65 years, but due to the severely increasing aging population, studies addressing surgical or oncological aspects are increasingly defining older age as ≥70 years 16 . Chronological age alone cannot be said to reflect the patient's physiological status; however, functional and nutritional status, cognition, mobility, and social support inevitably deteriorate with aging.…”