Abstract
Colorectal cancer surgery is frequently performed in the older population. Many older
persons have less physiological reserves and are thus more susceptible to adverse
postoperative outcomes. Therefore, it seems important to distinguish the fit patients
from the more vulnerable or frail. The aim of this review is to examine the evidence
regarding the impact of frailty on postoperative outcomes in older patients undergoing
surgery for colorectal cancer. A systematic literature search of Medline Ovid was
performed focusing on studies that examined the impact of frailty on postoperative
outcomes after colorectal surgery in older people aged ≥65 years. The methodological quality of the studies was evaluated using the MINORS quality
assessment. Five articles, involving four studies and 486 participants in total, were
included. Regardless of varying definitions of frailty and postoperative outcomes,
the frail patients had less favourable outcomes in all of the studies. Compared to
the non-frail group, the frail group had a higher risk of developing moderate to severe
postoperative complications, had longer hospital stays, higher readmission rates,
and decreased long-term survival rates. The results of this systematic review suggest
the importance of assessing frailty in older persons scheduled for colorectal surgery
because frailty is associated with a greater risk of postoperative adverse outcomes.
We conclude that, although there is no consensus on the definition of frailty, assessing
frailty in colorectal oncology seems important to determine operative risks and benefits
and to guide perioperative management.
Keywords
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Article info
Publication history
Published online: June 21, 2016
Accepted:
June 1,
2016
Received in revised form:
April 8,
2016
Received:
January 29,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
