Optimising surgical management of elderly cancer patients
- PDF / 758,391 Bytes
- 14 Pages / 610 x 792 pts Page_size
- 9 Downloads / 231 Views
Open Access
Review
Optimising surgical management of elderly cancer patients Hodigere Sripathy Jois Ramesh1, Daniel Pope2, Roberto Gennari3 and Riccardo A Audisio*4 Address: 1Department of Surgery, Whiston Hospital, Prescot – UK, 2University of Liverpool, Liverpool UK, 3European Institute of Oncology, Milan, Italy and 4Dept. of Surgery, Whiston Hospital, Prescot, UK & University of Liverpool, Liverpool, UK Email: Hodigere Sripathy Jois Ramesh - [email protected]; Daniel Pope - [email protected]; Roberto Gennari - [email protected]; Riccardo A Audisio* - [email protected] * Corresponding author
Published: 23 March 2005 World Journal of Surgical Oncology 2005, 3:17
doi:10.1186/1477-7819-3-17
Received: 14 September 2004 Accepted: 23 March 2005
This article is available from: http://www.wjso.com/content/3/1/17 © 2005 Ramesh et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Elderly population is on rise. It is an ethical dilemma how aggressive one should be when it comes to treat cancer in elderly. Presumed fear of increased postoperative morbidity and mortality has resulted in delivery of sub-optimal cancer surgery. Methods: In this review article we visit physiology of the aged, tools available to assess surgical risks in oncogeriatric patients, and current practice in the management of common cancers encountered in surgical oncology, with the view of increasing awareness on optimising surgical management of senior patients with cancer. A pubmed search for cancer, surgery, elderly, was carried out. Results: Cancer is on rise with increasing age predominantly affecting breast, gastrointestinal tract and lung. Increasingly more surgeons are offering surgery to elderly cancer patient but selection bias is prevalent. Available data reflect short and long-term outcome of cancer surgery in elderly is not greatly different to that of younger patient. Declining physiological reserve along with inability to respond adequately to physiological stress are salient age related changes. Comprehensive Geriatric Assessment (CGA) is not tested in surgical patient. There is need for a tool to define individualised operative risk. Preoperative assessment of cancer in elderly is designed to offer this information based on functional status of an individual utilising currently available tools of risk assessment. Conclusion: All elderly cancer patients should be offered optimal treatment depending on their functional status not on chronological age. Oncogeriatric patient would benefit from dedicated multidisciplinary approach. Recruitment of elderly cancer patients to more clinical trials is needed to enhance our knowledge and to offer optimum treatment to this unique subgroup.
Background The geriatric population is expanding, and hence the clin
Data Loading...
