Risk assessment for cancer surgery in elderly patients

Hodigere SJ Ramesh¹, Tom Boase², Riccardo A Audisio^1,2

¹Department of Surgery, Whiston Hospital, Prescot, Liverpool, Merseyside, UK; ²University of Liverpool, Liverpool, Merseyside, UK

Abstract: Global growth of the elderly population is requiring healthcare providers to cater for an expanding elderly cancer subpopulation. The aggression with which cancer should be treated in this subpopulation is an ethical dilemma and is an ongoing debate, as surgeons have feared increases in postoperative morbidity and mortality. As a result elderly patients often receive suboptimal cancer treatment. The need for standardization of cancer surgery is well recognized despite the difficulties in view of heterogeneity of the group. In this article, epidemiological changes, tumor biology specific to elderly cancer are visited, operative risk assessment tools are discussed, and interim results of ongoing multinational investigation ie, PACE (Preoperative Assessment of Cancer Elderly) revealed.

Keywords: Elderly, cancer, co-morbidity, surgery, PACE, operative risk