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KMID : 0371420221030030169
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Annals of Surgical Treatment and Research
2022 Volume.103 No. 3 p.169 ~ p.175
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Efficacy of geriatric multidisciplinary oncology clinic in the surgical treatment decision-making process for frail elderly patients with colorectal cancer
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Yang In-Jun
Oh Heung-Kwon
Lee Jee-Hye
Suh Jung-Wook
Ahn Hong-Min
Shin Hye-Rim
Kim Jin-Won
Kim Jee-Hyun
Song Chang-Hoon
Choi Jung-Yeon
Kim Duck-Woo
Kang Sung-Bum
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Abstract
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Purpose: Multidisciplinary care has become a cornerstone of colorectal cancer management. To evaluate the clinical efficacy of a geriatric multidisciplinary oncology clinic (GMOC), we analyzed the surgical treatment decision-making process and outcomes.
Methods: This retrospective single-center study reviewed the data of patients aged ≥65 years who participated in the GMOC at a tertiary referral hospital between 2015 and 2021. The clinical adherence rate, comprehensive geriatric assessment, and a multidimensional frailty score (MFS) were obtained. The groups that were recommended and not recommended for surgery were compared, analyzing the factors impacting the decision and 1-year survival outcomes. Furthermore, the postoperative complications of patients who underwent surgery were evaluated.
Results: A total of 165 patients visited the GMOC, and 74 had colorectal cancer (mean age, 85.5 years [range, 81.2?89.0 years]). Among patients with systemic disease (n = 31), 7 were recommended for surgery, and 5 underwent surgery. Among patients with locoregional disease (n = 43), 18 were recommended for surgery, and 12 underwent surgery. Patients recommended and not recommended for surgery had significantly different activities of daily living (ADL) (P = 0.024), instrumental ADL (P = 0.001), Mini-Mental State Examination (P = 0.014), delirium risk (P = 0.039), and MFS (P = 0.001). There was no difference in the 1-year overall survival between the 2 groups (P = 0.980). Of the 17 patients who underwent surgery, the median (interquartile range) of operation time was 165.0 minutes (120.0?270.0 minutes); hospital stay, 7.0 days (6.0?8.0 days); and 3 patients had wound complications.
Conclusion: Proper counseling of patients through the GMOC could lead to appropriate management and favorable outcomes.
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KEYWORD
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Colorectal neoplasms, Colorectal surgery, Frail elderly, Geriatric assessment, Patient care team
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