| Title: |
Comprehensive Geriatric Assessment, Treatment Decisions, and Outcomes in Older Patients Eligible for Pancreatic Surgery |
| Authors: |
Hartog, Marij; Beishuizen, Sara J. E.; Togo, Reon; van Bruchem-Visser, Rozemarijn L.; van Eijck, Casper H. J.; Mattace-Raso, Francesco U. S.; Pek, Chulja J.; de Wilde, Roeland F.; Koerkamp, Bas Groot; Polinder-Bos, Harmke A. |
| Source: |
Hartog, M, Beishuizen, S J E, Togo, R, van Bruchem-Visser, R L, van Eijck, C H J, Mattace-Raso, F U S, Pek, C J, de Wilde, R F, Koerkamp, B G & Polinder-Bos, H A 2024, 'Comprehensive Geriatric Assessment, Treatment Decisions, and Outcomes in Older Patients Eligible for Pancreatic Surgery', Journal of Surgical Oncology, vol. 130, no. 8, pp. 1643-1653. https://doi.org/10.1002/jso.27862 |
| Publication Year: |
2024 |
| Subject Terms: |
/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; name=SDG 3 - Good Health and Well-being |
| Description: |
Introduction: Periampullary cancer has a poor prognosis. Surgical resection is a potentially curative but high-risk treatment. Comprehensive geriatric assessment (CGA) can inform treatment decisions, but has not yet been evaluated in older patients eligible for pancreatic surgery. Methods: This prospective observational study included patients >= 70 years of age eligible for pancreatic surgery. Frailty was defined as impairment in at least two of five domains: somatic, psychological, functional, nutritional, and social. Outcomes included postoperative complications, functional decline, and mortality. Results: Of the 88 patients included, 87 had a complete CGA. Sixty-five patients (75%) were frail and 22 (25%) were non-frail. Frail patients were more likely to receive nonsurgical treatment (43.1% vs. 9.1% p = 0.004). Fifty-seven patients underwent surgery, of which 52 (59%) underwent pancreaticoduodenectomy. The incidence of postoperative delirium was three times higher in frail patients (29.7% vs. 0%, p = 0.005). The risk of mortality was three times higher in frail patients (HR: 3.36, 95% CI: 1.43-7.89, p = 0.006). Conclusion: Frailty is common in older patients eligible for pancreatic surgery and is associated with treatment decision, a higher incidence of delirium and a three times higher risk of all-cause mortality. CGA can contribute to shared decision-making and optimize perioperative care in older patients. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
0022-4790; 1096-9098 |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/39290062; info:eu-repo/semantics/altIdentifier/wos/001314783200001; info:eu-repo/semantics/altIdentifier/pissn/0022-4790; info:eu-repo/semantics/altIdentifier/eissn/1096-9098 |
| DOI: |
10.1002/jso.27862 |
| Availability: |
https://pure.eur.nl/en/publications/0c4b7e96-3f08-4a4e-b77c-614c53c7dd56; https://doi.org/10.1002/jso.27862; https://pure.eur.nl/ws/files/168294920/Comprehensive_Geriatric_Assessment_Treatment_Decisions_and_Outcomes_in_Older_Patients_Eligible_for_Pancreatic_Surgery.pdf; https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=eur_pure&SrcAuth=WosAPI&KeyUT=WOS:001314783200001&DestLinkType=FullRecord&DestApp=WOS_CPL |
| Rights: |
info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.D6C28981 |
| Database: |
BASE |