Preoperative assessment of surgical risk in oncogeriatric patients
Preoperative assessment of surgical risk in oncogeriatric patients
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DOI：
10.1634/theoncologist.10-4-262
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发表时间：
2005-04-01
期刊：
影响因子：
5.8
通讯作者：
Pope, D
中科院分区：
文献类型：
--
作者：
Audisio, RA;Ramesh, H;Pope, D
癌症是一种常见的疾病，在我们的人口老龄化，然而，很少有肿瘤学家熟悉照顾老年肿瘤患者。手术目前是大多数实体瘤的治疗选择，但在这种患者亚群中，手术常常以次优的方式进行。治疗不足往往是合理的，担心一个不可持续的毒性，而过度治疗可能与缺乏知识，优化术前风险评估。为了对这个问题有新的认识，几位外科医生提出了他们的系列，提供了确凿的证据，证明可以为老年癌症患者提供手术选择，只有有限的术后死亡率和发病率。由于这些数据中的大部分可能存在选择偏倚，因此我们将重点放在综合老年评估（CGA）上，这可以增加老年癌症患者功能评估的大量信息。一个有效的工具，如CGA允许比较系列，更准确地预测短期手术结果，并提供适当的信息时，同意老年患者。老年人癌症术前评估是一项前瞻性国际研究，旨在概述患有恶性肿瘤的老年手术患者的健康状况。本文报告了正在进行的研究的初步结果和分析。
Cancer is a prevalent disease in our aging population; however, few oncologists are familiar with caring for oncogeriatric patients. Surgery is presently the treatment of choice for most solid tumors, but it is frequently delivered in a suboptimal way in this patient subsetting. Undertreatment is often justified with the concern of an unsustainable toxicity, while overtreatment can be related to the lack of knowledge in optimizing preoperative risk assessment. To draw new light on this issue, several surgeons presented their series, providing hard evidence that surgical options can be offered to the elderly with cancer, with only a limited postoperative mortality and morbidity. As it is likely that much of these data suffer from selection bias, we concentrated on Comprehensive Geriatric Assessment (CGA), which can add substantial information on the functional assessment of elderly cancer patients. A validated instrument such as the CGA allows a comparison of series, predicting short-term surgical outcomes more precisely, and offers appropriate information when consenting elderly patients. Preoperative Assessment of Cancer in the Elderly is a prospective international study conceived and launched to outline the fitness of elderly surgical patients with malignant tumors. This paper reports on preliminary results and analysis from the ongoing study.