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Geriatric assessments cancer surgery

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https://www.readbyqxmd.com/read/29411331/association-of-pre-operative-medication-use-with-post-surgery-mortality-and-morbidity-in-oncology-patients-receiving-comprehensive-geriatric-assessment
#1
Kyung Suk Choi, Young Mi Jeong, Eunsook Lee, Kwang Ill Kim, Jeong Yee, Byung Koo Lee, Jee Eun Chung, Sandy Jeong Rhie, Hye Sun Gwak
BACKGROUND: Comprehensive geriatric assessment (CGA) has become a predictor for elderly cancer patients in post-surgical complications, including post-discharge institutionalization and mortality. AIMS: To determine whether pre-operative medication use is associated with post-operative morbidity and mortality in oncology patients receiving CGA. METHODS: Patients aged 65 years or older who were scheduled for cancer surgery and presented for CGA were included in the present study...
February 6, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29359461/risk-factors-for-30-day-complications-after-cancer-surgery-in-geriatric-patients-a-secondary-analysis
#2
K Scholtz, C D Spies, R Mörgeli, R Eckardt, V von Dossow, S Braun, J Sehouli, M Bahra, C G Stief, K-D Wernecke, M Schmidt
BACKGROUND: The aim was to analyse the association between severity of complications up to 30 days after surgery and pre-operative nutritional and physical performance parameters. METHODS: The participants were a subsample of the previously published PERATECS study (ClinicalTrials.gov: NCT01278537) and included 517 onco-geriatric patients aged ≥ 65 years, undergoing thoracoabdominal, gynaecological, or urological surgery. Post-operative complications were classified according to the Clavien Classification System (CCS)...
January 22, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29240884/a-proposal-for-a-comprehensive-risk-scoring-system-for-predicting-postoperative-complications-in-octogenarian-patients-with-medically-operable-lung-cancer-jacs1303
#3
Hisashi Saji, Takahiko Ueno, Hiroshige Nakamura, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Takuro Miyazaki, Keiju Aokage, Masayuki Nakao, Tomohiro Haruki, Hiroyuki Ito, Kazuhiko Kataoka, Kazunori Okabe, Kenji Tomizawa, Kentaro Yoshimoto, Hirotoshi Horio, Kenji Sugio, Yasuhisa Ode, Motoshi Takao, Morihito Okada, Masayuki Chida
OBJECTIVES: Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial. METHODS: The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications...
December 11, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29238654/primary-endocrine-therapy-in-older-women-with-breast-cancer
#4
REVIEW
R M C Pepping, J E A Portielje, W van de Water, N A de Glas
Purpose of Review: Breast cancer incidence increases with age. In recent years, primary endocrine therapy has been increasingly used as a treatment option for frail elderly women with breast cancer, although surgery is still the guideline-recommended treatment. In this review, we discuss the evidence for primary endocrine therapy versus surgical treatment in older women with early breast cancer. Recent Findings: Both randomised controlled trials and recent observational studies showed a favourable progression-free survival but not overall survival for surgery plus adjuvant endocrine therapy versus primary endocrine therapy...
2017: Current Geriatrics Reports
https://www.readbyqxmd.com/read/29184443/training-surgeons-in-shared-decision-making-with-cancer-patients-aged-65-years-and-older-a-pilot-study
#5
Noralie H Geessink, Yvonne Schoon, Marcel Gm Olde Rikkert, Harry van Goor
Objective: Treatment decision-making in older patients with colorectal (CRC) or pancreatic cancer (PC) needs improvement. We introduced the EASYcare in Geriatric Onco-surgery (EASY-GO) intervention to optimize the shared decision-making (SDM) process among these patients. Methods: The EASY-GO intervention comprised a working method with geriatric assessment and SDM training for surgeons. A non-equivalent control group design was used. Newly diagnosed CRC/PC patients aged ≥65 years were included...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/29129470/risk-stratification-for-surgical-outcomes-in-older-colorectal-cancer-patients-using-isar-hp-and-g8-screening-tools
#6
Esteban T D Souwer, Norbert M Verweij, Frederiek van den Bos, Esther Bastiaannet, Rob M E Slangen, Willem H Steup, Marije E Hamaker, Johanna E A Portielje
BACKGROUND: Older patients are at risk for adverse outcomes after surgical treatment of cancer. Identifying patients at risk could affect treatment decisions and prevent functional decline. Screening tools are available to select patients for Geriatric Assessment. Until now their predictive value for adverse outcomes in older colorectal cancer patients has not been investigated. OBJECTIVE: To study the predictive value of the Geriatric 8 (G8) and Identification of Seniors at Risk for Hospitalized Patients (ISAR-HP) screening tools for adverse outcomes after elective colorectal surgery in patients older than 70years...
November 9, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29075972/clinical-benefits-of-single-incision-laparoscopic-surgery-for-postoperative-delirium-in-elderly-colon-cancer-patients
#7
Yujiro Nishizawa, Taishi Hata, Ichiro Takemasa, Makoto Yamasaki, Hiroshi Akasaka, Ken Sugimoto, Koki Tamai, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Chu Matsuda, Tsunekazu Mizushima, Masakazu Ikenaga, Hirofumi Yamamoto, Kohei Murata, Hiromi Rakugi, Yuichiro Doki, Masaki Mori
BACKGROUND: The number of elderly patients with colon cancer is increasing in Japan. Postoperative delirium (POD) is a major complication for elderly patients who undergo surgery, and postoperative pain is a common inducer of POD. We reported previously that single-incision laparoscopic surgery (SLS) significantly reduces postoperative pain compared to conventional laparoscopic surgery (CLS). Data are lacking about the effect of SLS on POD. This retrospective study evaluated the clinical benefits of SLS for POD in elderly patients with colon cancer...
October 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29034253/risk-factors-for-adverse-outcome-for-elderly-patients-undergoing-curative-oncological-resection-for-gastrointestinal-malignancies
#8
REVIEW
Yukai K Lim, Christopher Jackson, Emilia L Dauway, Konrad Klaus Richter
BACKGROUND: The incidence of gastrointestinal cancer increases with age, with approximately 20% of these cases in people over 80 years of age. Due to pre-existing comorbidities, this onco-geriatric population often presents diagnostic and therapeutic challenges. METHODS: A systematic review of articles on PubMed was performed to determine the predictive ability of screening tools and their components regarding the occurrence of adverse outcomes in elderly onco-surgical patients with gastrointestinal malignancies...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#9
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/28967093/advances-in-geriatric-oncology-a-multidisciplinary-perspective
#10
Ponnandai Somasundar, Loïc Mourey, Laura Lozza, Stefania Maggi, Rob Stepney
A growing majority of people with cancer is composed of older patients. For many such patients, independence and quality of life are as important as prolongation of survival, emphasizing the need for treatments that are not only effective but also well-tolerated. Given age-related decline in organ function and the prevalence of comorbidities and polypharmacy, optimum management is complex and requires collaboration between oncologists and geriatricians. Advances in surgery now include preoperative assessment and, when indicated, prehabilitation of the patient, as well as the enhanced recovery after surgery approach...
September 27, 2017: Tumori
https://www.readbyqxmd.com/read/28966807/skin-cancer-epidemics-in-the-elderly-as-an-emerging-issue-in-geriatric-oncology
#11
REVIEW
Simone Garcovich, Giuseppe Colloca, Pietro Sollena, Bellieni Andrea, Lodovico Balducci, William C Cho, Roberto Bernabei, Ketty Peris
Skin cancer is a worldwide, emerging clinical need in the elderly white population, with a steady increase in incidence rates, morbidity and related medical costs. Skin cancer is a heterogeneous group of cancers comprising cutaneous melanoma and non-melanoma skin cancers (NMSC), which predominantly affect elderly patients, aged older than 65 years. Melanoma has distinct clinical presentations in the elderly patient and represents a challenging question in terms of clinical management. NMSC includes the basal cell carcinoma and cutaneous squamous cell carcinoma and presents a wide disease spectrum in the elderly population, ranging from low-risk to high-risk tumours, advanced and inoperable disease...
October 2017: Aging and Disease
https://www.readbyqxmd.com/read/28958666/pearls-of-optimizing-nutrition-and-physical-performance-of-older-adults-undergoing-cancer-therapy
#12
Antonio Vigano, Popi Kasvis, Jonathan Di Tomasso, Chelsia Gillis, Robert Kilgour, Franco Carli
As the global population continues to age, the prevalence of cancer is increasing, with more than half of new cancer diagnoses occurring in those aged 65years and older. As a result of improved oncological care, a greater number of older patients undergo treatment, either chemoradiotherapy or surgery or both. The older oncology patient is not part of a homogenous group; chronological age poorly describes the health status of an individual. Comprehensive geriatric assessment (CGA) identifies domains, assessed by a multidisciplinary team, that should be considered to guide appropriate oncological treatment decisions...
November 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28888555/functional-impairment-prior-to-major-non-cardiac-surgery-is-associated-with-mortality-within-one-year-in-elderly-patients-with-gastrointestinal-gynaecological-and-urogenital-cancer-a-prospective-observational-cohort-study
#13
Maren Schmidt, Rahel Eckardt, Sarah Altmeppen, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVE: To investigate the prognostic value of elements of the Geriatric Assessment, in particular the Timed Up and Go (TUG) Test and the Barthel Index of Activities of Daily Living (ADL) for one-year post-operative mortality in elderly patients with cancer. MATERIALS AND METHODS: This prospective cohort study included patients 65years of age or older undergoing elective major surgery for cancer between June 2008 and June 2010. Preoperative functional status was measured by the TUG Test and the Barthel Index of ADL Cognitive state was assessed by the Mini Mental State Examination (MMSE)...
September 6, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28797032/comprehensive-geriatric-assessment-in-326-older-women-with-early-breast-cancer
#14
MULTICENTER STUDY
D O Okonji, R Sinha, I Phillips, D Fatz, A Ring
BACKGROUND: One-third of new early breast cancer diagnoses occur in women over 70 years old. However, older women are less likely to receive radical curative treatments. This study prospectively evaluated a cohort of older women using a Comprehensive Geriatric Assessment (CGA) to determine whether fitness explained the apparent under-treatment in this patient group. METHODS: In this multi-centre prospective study, patients aged ⩾70 years with Stages I-III breast cancer underwent a pretreatment baseline CGA consisting of eight assessment tools...
September 26, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28781062/value-of-geriatric-screening-and-assessment-in-predicting-postoperative-complications-in-patients-older-than-70-years-undergoing-surgery-for-colorectal-cancer
#15
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
OBJECTIVES: This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC). MATERIALS AND METHODS: Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST)...
September 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28776893/preoperative-medication-use-and-its-association-with-postoperative-length-of-hospital-stay-in-surgical-oncology-patients-receiving-comprehensive-geriatric-assessment
#16
Young Mi Jeong, Kyung Eun Lee, Eun Sook Lee, Kwang Ill Kim, Jee Eun Chung, Byung Koo Lee, Hye Sun Gwak
AIM: The present study aimed to investigate whether preoperative medication use is associated with postoperative length of hospital stay in older adults undergoing cancer surgery. METHODS: Patients aged ≥65 years who were scheduled for cancer surgery and presented for preoperative comprehensive geriatric assessment were included in the present study. Cognitive function evaluation and preoperative medication review were carried out, as well as baseline characteristics of participants collected from electronic medical records...
August 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#17
K Fagard, J Casaer, A Wolthuis, J Flamaing, K Milisen, J-P Lobelle, H Wildiers, C Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer. METHOD: Patients ≥ 70 years old were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
September 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28705182/chemoradiation-in-elderly-esophageal-cancer-patients-rationale-and-design-of-a-phase-i-ii-multicenter-study-osage
#18
Stéphanie Servagi-Vernat, Gilles Créhange, Franck Bonnetain, Cécile Mertens, Etienne Brain, Jean François Bosset
BACKGROUND: The management of elderly patients with cancer is a therapeutic challenge and a public health problem. Definitive chemoradiotherapy (CRT) is an accepted standard treatment for patients with locally advanced esophageal cancer who cannot undergo surgery. However, there are few reports regarding tolerance to CRT in elderly patients. We previously reported results for CRT in patients aged ≥75 years. Following this first phase II trial, we propose to conduct a phase I/II study to evaluate the combination of carboplatin and paclitaxel, with concurrent RT in unresectable esophageal cancer patients aged 75 years or older...
July 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28649755/preoperative-geriatric-assessment-and-tailored-interventions-in-frail-older-patients-with-colorectal-cancer-a-randomised-controlled-trial
#19
Nina Ommundsen, Torgeir B Wyller, Arild Nesbakken, Arne O Bakka, Marit S Jordhøy, Eva Skovlund, Siri Rostoft
BACKGROUND: Colorectal cancer (CRC) is prevalent in the older population, and surgery is the mainstay in curative treatment. A preoperative geriatric assessment (GA) can identify frail older patients at risk for developing postoperative complications. In this randomised controlled trial we wanted to investigate whether tailored interventions based on a preoperative GA could reduce the frequency of postoperative complications in frail patients operated for CRC. METHODS: Patients >65 years scheduled for elective CRC surgery and fulfilling predefined criteria for frailty were randomised to either a preoperative GA followed by a tailored intervention, or care as usual...
June 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28602710/controversial-issues-in-the-management-of-older-adults-with-early-breast-cancer
#20
REVIEW
Anna Rachelle Mislang, Kwok-Leung Cheung, Marije E Hamaker, Ian Kunkler, Christos Markopoulos, Roberto Orecchia, Etienne Brain, Laura Biganzoli
It is well recognized that the incidence of breast cancer increases significantly with age. Despite this, older people remain under-represented in many clinical trials and their management relies on extrapolation of data from younger patients. Providing an aggressive intervention can be challenging, particularly in less fit older patients where a conservative approach is commonly perceived to be more appropriate. The optimal management of this population is unknown and treatment decision should be personalized...
November 2017: Journal of Geriatric Oncology
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