Perioperative care/assessment
A number of elderly cancer patients do not receive standard surgery for solid tumors because they are considered unfit for treatment as a consequence of inaccurate estimation of the operative risk. To tailor treatment to onco-geriatric series, oncologists are now beginning to use a comprehensive geriatric assessment (CGA). This study investigates the value of an extended CGA in assessing the suitability of elderly patients for surgical intervention.
Surgical management
Based on the observation that both surgical under-treatment – justified by concerns about unsustainable toxicity – and surgical over-treatment of elderly cancer patients – explained by insufficient assessment of preoperative risk – are too frequent, the taskforce pointed out differences from, and similarities to the younger cohorts of cancer patients, and edicted their first recommendations helping to avoid both under- and over-treatment.
The taskforce then investigated the value of an extended CGA in assessing the suitability of elderly patients for surgery for solid tumors and results were published.
NB:
– The PACE study was approved by Multi-centre Research Ethics Committee and received no funding.
– It is also suggested to read the book on PACE by Ramesh Jois
PREOP – Preoperative Risk Estimation for Onco-geriatric Patients – is a medical study currently undertaken in cooperation with the SIOG Surgical Taskforce, with the objective of optimising the pre-operative assessment for elderly cancer patients. The full report is available here:
surgical_tf_preop_report.pdf
Chair: Ponnandai Somasundar, USA
Members:
Daniel Anaya, USA
Riccardo A. Audisio, UK
Federico Bozzetti, Italy
K.L. Cheung, UK
Nicola de Liguori Carino, UK
Michael T. Jaklitsch, USA
Massimo Maffezzini, Italy
Isacco Montroni, Italy
Malcolm Reed, UK
Giampaolo Ugolini, Italy
Barbara van Leeuwen, Netherlands
Thomas Warkus, Canada
Malcolm West, UK
2015
Ghignone F, van Leeuwen BL, Montroni I, Huisman MG, Somasundar P, Cheung KL, Audisio RA, Ugolini G; International Society of Geriatric Oncology (SIOG) Surgical Task Force. The assessment and management of older cancer patients: A SIOG surgical task force survey on surgeons’ attitudes. Eur J Surg Oncol. 2015 Dec 17. pii: S0748-7983(15)00903-8. doi: 10.1016/j.ejso.2015.12.004. [Epub ahead of print]
The surgical management of elderly cancer patients: recommendations of the SIOG surgical task force (position paper). Audisio RA, et Eur J Cancer 2004; 40: 926-38