The impact of frailty on postoperative outcomes in individuals aged 65 and over undergoing elective surgery for colorectal cancer: A systematic review

Fagard, Katleen; Leonard, Silke; Deschodt, Mieke; Devriendt, Els; Wolthuis, Albert; Prenen, Hans; Flamaing, Johan; Milisen, Koen; Wildiers, Hans; Kenis, Cindy

doi:10.1016/j.jgo.2016.06.001

Cited by 175 publications

(129 citation statements)

References 43 publications

Supporting

Mentioning

117

Contrasting

Order By: Relevance

“…[21][22][23][24] In fact, our results also confirm prior findings on the increased LOS in >60-years-old after donor nephrectomy. [21][22][23][24] In fact, our results also confirm prior findings on the increased LOS in >60-years-old after donor nephrectomy.…”

Section: Discussionsupporting

confidence: 91%

Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

Serrano

Yadav

Bangdiwala

et al. 2018

Clinical Transplantation

View full text Add to dashboard Cite

With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1.73 m ; P < .001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3% vs 7%; P = .021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P = .005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P < .001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.

show abstract

Section: Discussionsupporting

confidence: 91%

Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

Serrano

Yadav

Bangdiwala

et al. 2018

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…Poor physical and role functioning in the elderly may result in patients' inability to perform daily activities or self-care, and therefore emphasizes the need to predict this subgroup at risk for postoperative complications to take precautions in clinical, pre-or post-treatment care. A pretreatment frailty assessment may be of added value to estimate risks and benefits of perioperative management [9] and thereby to predict functioning after treatment. Frailty, which indicates the progressive disability resulting from a generalized decline in multiple physiological systems, negatively affects functional reserves and increases vulnerability to adverse outcomes [38].…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review on the impact of frailty on postoperative outcomes in the elderly undergoing elective surgery for colorectal cancer, concluded that frail older patients have a significantly higher risk of postoperative complications compared to the non-frail older patients [9]. Frailness and a tumor located in the rectum were previously reported as independent predictors of severe complications in older patients [10].…”

Section: Introductionmentioning

confidence: 99%

The impact of postoperative complications on health-related quality of life in older patients with rectal cancer; a prospective cohort study

Couwenberg

Beer

Intven

et al. 2018

Journal of Geriatric Oncology

View full text Add to dashboard Cite

a b s t r a c t a r t i c l e i n f oObjectives: As result of the aging population and increasing rectal cancer incidence, more older patients undergo treatment for rectal cancer. This study compares treatment course, postoperative complications, and quality of life (QOL) between older and younger patients with rectal cancer and evaluates the impact of postoperative complications on QOL in the elderly. Materials and Methods: Patients with rectal cancer participating in a prospective colorectal cancer cohort and referred for radiotherapy between 2013 and 2016 were included. QOL was assessed with the cancer questionnaire of the European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30) before treatment and at three, six, and twelve months. Outcomes were compared between older patients (≥70 years) and younger patients (b 70 years) and stratified by presence of postoperative complications. Results: In total, 115 (33%) older patients and 230 (67%) younger patients were included. Compared to younger patients, older patients underwent significantly more often short-course radiation with delayed surgery (6.1% and 19.1% respectively) and less often chemoradiation (62.6% and 39.1% respectively), and were more likely to undergo a Hartmann procedure with permanent stoma (3.5% and 13.0% respectively) instead of sphincter-sparing surgery (43.9% and 29.6% respectively). Postoperative complication rates were similar (38.5% in older patients versus 34.7% in younger patients). Older patients had worse physical functioning at six and twelve months after diagnosis compared to younger patients. Presence of postoperative complications had a significant stronger impact on physical-and role functioning in older patients. Conclusion: Older patients undergo more often a tailored treatment approach for rectal cancer than younger patients. With this tailored approach, similar postoperative complication rates and QOL are achieved. However, postoperative complications have a larger negative impact on physical-and role functioning in older patients which indicates a need for better prediction of postoperative complications in the elderly.

show abstract

“…Because age, frailty, and sarcopenia are associated with risk of perioperative morbidity and mortality in gastrointestinal cancers, the survival differences of age groups are explained [19,20]. However, there is evidence that minimally invasive techniques can be safely performed with functional and oncological equivalent in older colorectal cancer patients and may be an option for gastric cancer therapy in the near future [21,22].…”

Section: Discussionmentioning

confidence: 99%

Age and Outcome in Gastrointestinal Cancers: A Population-Based Evaluation of Oesophageal, Gastric and Colorectal Cancer

et al. 2017

View full text Add to dashboard Cite

Background: With demographic changes and partial representativeness of randomized studies the question arises which results are achieved in the treatment of the elderly. The objective was to analyse population-based data on gastrointestinal cancers in terms of age. Methods: Analyses included data of the Munich Cancer Registry, i.e. 4,014, 10,127 and 42,809 invasive oesophageal, gastric and colorectal cancer patients, respectively, which were diagnosed between 1998 and 2014. Tumour characteristics and outcome were analysed by age groups and therapy. Overall survival was analysed using the Kaplan-Meier method, and relative survival was computed as estimation for cancer-specific survival. Additionally, conditional survival of patients surviving at least 6 or 12 months was analysed by age. Results: 21, 44 and 38% of oesophageal, gastric and colorectal cancer patients, respectively, were aged >75 years. Of these, 15, 46 and 73% were surgically treated with curative intent, respectively, which is significantly less than in younger patients. The total 5-year relative survival was 24, 33 and 66%, respectively. The differences in median survival by age group were diminished by selecting those surviving at least 6 or 12 months and those with curatively intended treatment. Conclusion: An adequate patient selection for therapies of these gastrointestinal cancers was demonstrated at large. If the patients' general conditions allowed curatively intended treatment, it was applied and led to similar outcomes irrespective of age.

show abstract

The impact of frailty on postoperative outcomes in individuals aged 65 and over undergoing elective surgery for colorectal cancer: A systematic review

Cited by 175 publications

References 43 publications

Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

The impact of postoperative complications on health-related quality of life in older patients with rectal cancer; a prospective cohort study

Age and Outcome in Gastrointestinal Cancers: A Population-Based Evaluation of Oesophageal, Gastric and Colorectal Cancer

Contact Info

Product

Resources

About