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Published in: World Journal of Surgery 4/2021

01-04-2021 | Colorectal Cancer | Original Scientific Report

Optimal Assessment of Frailty Predicts Postoperative Complications in Older Patients with Colorectal Cancer Surgery

Authors: Koichi Tamura, Kenji Matsuda, Yoichi Fujita, Makoto Iwahashi, Kazunari Mori, Naohisa Yamade, Tsukasa Hotta, Kohei Noguchi, Yoshifumi Sakata, Katsunari Takifuji, Hiromitsu Iwamoto, Yuki Mizumoto, Hiroki Yamaue

Published in: World Journal of Surgery | Issue 4/2021

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Abstract

Objectives

The increasingly elderly worldwide population has affected the incidence of colorectal cancer. Establishment of reliable assessment of frailty and proposals for multi-disciplinary interventions are urgently required in oncology practices. Kihon Checklist (KCL) was published by the Japanese Ministry of Health, Labor and Welfare originally to identify individuals ≥ 65 years old at probable risk for requiring care or social support. We investigate the validity of KCL for frailty assessment to predict postoperative complication in older patients with colorectal cancer.

Methods

Consecutive colorectal cancer patients aged ≥ 65 (n = 500) were prospectively examined between May 2017 and December 2018. Preoperative frailty assessment was conducted by the G8 questionnaire and KCL. The main outcome measures were correlation between frailty, other clinical variables, and postoperative complications within 30 days after elective surgery.

Results

Of the 500 patients, 278 (55.6%) and 164 (32.8%) patients were classified as ‘frail’ by G8 and KCL, respectively. Overall complications counted among 97 patients (19.4%), and they were significantly associated with KCL ≥ 8-frail (46/164, p = 0.001), as opposed to G8 ≤ 14-frail (56/278, p = 0.531). Multivariate analysis showed that KCL ≥ 8 (hazard ratio 1.88, 95% confidence interval 1.16–3.04, p = 0.011) was an independent risk factor for these complications.

Conclusions

KCL assessment can identify frail older patients likely to suffer from postoperative complications after colorectal cancer surgery. Preoperative screening of frailty, particularly by KCL, would help older patients prevent their worse outcomes in colorectal cancer.

Trial registration

UMIN000026689.
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Metadata
Title
Optimal Assessment of Frailty Predicts Postoperative Complications in Older Patients with Colorectal Cancer Surgery
Authors
Koichi Tamura
Kenji Matsuda
Yoichi Fujita
Makoto Iwahashi
Kazunari Mori
Naohisa Yamade
Tsukasa Hotta
Kohei Noguchi
Yoshifumi Sakata
Katsunari Takifuji
Hiromitsu Iwamoto
Yuki Mizumoto
Hiroki Yamaue
Publication date
01-04-2021
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 4/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05886-4

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