Impact of comprehensive geriatric assessment on treatment strategies and complications in older adults with colorectal cancer considering surgery

Background and Objectives This study aimed to assess the effectiveness of Comprehensive Geriatric Assessment (CGA) in customizing care for elderly cancer patients, specifically focusing on colorectal cancer. The research compared treatment strategies and outcomes in older adults considered for surge...

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Published in:Journal of surgical oncology 2024-08, Vol.130 (2), p.329-337
Main Authors: Sugiyama, Masahiko, Nishijima, Tomohiro F., Kasagi, Yuta, Uehara, Hideo, Yoshida, Daisuke, Nagai, Taichiro, Koga, Naomichi, Kimura, Yasue, Morita, Masaru, Toh, Yasushi
Format: Article
Language:English
Subjects:
CGA
Colorectal cancer
comprehensive geriatric assessment
frailty
Geriatrics
Older people
Surgery
Surgical outcomes
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Summary:Background and Objectives This study aimed to assess the effectiveness of Comprehensive Geriatric Assessment (CGA) in customizing care for elderly cancer patients, specifically focusing on colorectal cancer. The research compared treatment strategies and outcomes in older adults considered for surgery before and after the initiation of a Geriatric Oncology Service (GOS). Methods Conducting a comparative study, two cohorts of consecutive colorectal cancer patients aged 75 or older were examined: the control group (n = 156) and the GOS group (n = 158). Upon the treating surgeon's GOS consultation request, a geriatrician and an oncologist performed CGA, guiding treatment decisions and perioperative interventions. Postoperative complications were compared using propensity score matching (PSM). Results In the GOS group, 91% (n = 116) underwent CGA consultations, influencing decisions to forego surgery in 12 patients. After PSM for surgical cases (controls n = 146, GOS n = 146), each group comprised 128 patients. Perioperative physical therapy and pharmacist referrals were more frequent in the GOS group. The GOS group exhibited a significantly lower incidence of postoperative complications (22%) compared to the control group (33%) (p = 0.0496). Conclusion Patients undergoing colorectal surgery post‐GOS implementation experienced a notable reduction in postoperative complications, highlighting the positive impact of personalized geriatric assessment on surgical outcomes in the elderly.
ISSN:0022-4790
1096-9098
1096-9098
DOI:10.1002/jso.27736