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Oncogeriatrics (part 4.) Pre-operative assessment of elderly patients with cancer
Affiliations- Department of General, Oncological and Geriatric Surgery, Jagiellonian University Medical College, Krakow, Poland
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Abstract
Older patients comprise a highly heterogeneous group, and chronological age, comorbidities, or the type of surgical procedure performed cannot adequately describe the risk of adverse post-operative outcomes. Therefore, current routine pre-operative assessment also cannot adequately identify patients at risk. The Comprehensive Geriatric Assessment, the mean life expectancy and the treatment goals of a patient must be included in the pre-operative evaluation. The Comprehensive Geriatric Assessment helps to determine the primary status of an older patient, to diagnose frailty syndrome and to identify how to optimize a patient’s condition before surgery. Surgery is one of the primary triggers for disability in older patients. In this age group, being independent is more important than prolonging life. This is particularly true in patients with frailty syndrome, or decreased physiological reserves, which arise from cumulative deficits in several physiological systems and result in a diminished resistance to stressors. Therefore, a standardized pre-operative diagnostic approach, individualized surgical technique selection and tailored post-operative care are essential for successful treatment of elderly patients.
Abstract
Older patients comprise a highly heterogeneous group, and chronological age, comorbidities, or the type of surgical procedure performed cannot adequately describe the risk of adverse post-operative outcomes. Therefore, current routine pre-operative assessment also cannot adequately identify patients at risk. The Comprehensive Geriatric Assessment, the mean life expectancy and the treatment goals of a patient must be included in the pre-operative evaluation. The Comprehensive Geriatric Assessment helps to determine the primary status of an older patient, to diagnose frailty syndrome and to identify how to optimize a patient’s condition before surgery. Surgery is one of the primary triggers for disability in older patients. In this age group, being independent is more important than prolonging life. This is particularly true in patients with frailty syndrome, or decreased physiological reserves, which arise from cumulative deficits in several physiological systems and result in a diminished resistance to stressors. Therefore, a standardized pre-operative diagnostic approach, individualized surgical technique selection and tailored post-operative care are essential for successful treatment of elderly patients.
Keywords
older patient; pre-operative assessment; comprehensive geriatric assessment
About this articleTitle
Oncogeriatrics (part 4.) Pre-operative assessment of elderly patients with cancer
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
16-19
Published online
2020-03-03
Page views
1788
Article views/downloads
556
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2020;70(1):16-19.
Keywords
older patient
pre-operative assessment
comprehensive geriatric assessment
Authors
Jakub Kenig
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