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1. GOSAFE - Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery: early analysis on 977 patients

Author

Montroni, I, Rostoft, S, Spinelli, A, Van Leeuwen, BL, Ercolani, G, Saur, NM, Jaklitsch, MT, Somasundar, PS, Carino, ND, Ghignone, F, Foca, F, Zingaretti, C, Audisio, RA, Ugolini, G, Garutti, A, Taffurelli, G, Zattoni, D, Tramelli, P, Sermonesi, G, Di Candido, F, Carvello, M, Sacchi, M, De Lucia, F, Foppa, C, Plas, M, Van der Wal-Huisman, H, Tauceri, F, Perenze, B, Di Pietrantonio, D, Mirarchi, M, Fejka, M, Bleier, JIS, Frain, L, Fox, SW, Cardin, K, De Leon, LE, Baltatzis, M, Chan, AKC, Siriwardena, AK, Vertogen, B, Nanni, O, Garulli, G, Alagna, V, Pirrera, B, Lucchi, A, Monari, F, Conti, L, Capelli, P, Romboli, A, Palmieri, G, Banchini, F, Marano, L, Spaziani, A, Castagnoli, G, Bartoli, A, Trompetto, M, Gallo, G, Luc, AR, Clerico, G, Sammarco, G, De Luca, R, Barile, G, Simone, M, Costanzi, A, Mari, G, Maggioni, D, Pellegrino, R, Riggio, V, Kenig, J, Szabat, K, Scabini, S, Pertile, D, Stratta, E, Massobrio, A, Soriero, D, Nesbakken, A, Lonn, M, Backe, IF, Ferrari, G, Mazzola, M, Alampi, BDA, Achilli, P, Sfondrini, S, Ioannidis, O, Loutzidou, L, Galanos-Demiris, K, Pellino, G, Balducci, G, Frezza, B, Lucarini, A, Santos, C, Cooper, L, Siam, B, Levy, Y, Brenner, B, Kashtan, H, Belgrano, V, De Cian, F, Palermo, B, Eggenhoffner, R, Albertelli, M, Sanchez-Guillen, L, Arroyo, A, Lopez-Rodriguez, F, Lario, S, Lillo, C, Wexner, SD, SIOG Surgical Task Force, and ESSO GOSAFE Study Grp

Subjects
MULTICENTER, CANCER
Abstract

Objective: Older patients with cancer value functional outcomes as much as survival, but surgical studies lack functional recovery (FR) data. The value of a standardized frailty assessment has been confirmed, yet it's infrequently utilized due to time restrictions into everyday practice. The multicenter GOSAFE study was designed to (1) evaluate the trajectory of patients' quality of life (QoL) after cancer surgery (2) assess baseline frailty indicators in unselected patients (3) clarify the most relevant tools in predicting FR and clinical outcomes. This is a report of the study design and baseline patient evaluations. Materials & Methods: GOSAFE prospectively collected a baseline multidimensional evaluation before major elective surgery in patients (70 years) from 26 international units. Short-/mid-/Iong-term surgical outcomes were recorded with QoL and FR data. Results: 1003 patients were enrolled in a 26-month span. Complete baseline data were available for 977(97.4%). Median age was 78 years (range 70-94); 52.8% males. 968(99%) lived at home, 51.6% without caregiver. 54.4% had 3 medications, 5.9% none. Patients were dependent (ADL < 5) in 7.9% of the cases. Frailty was either detected by G8 = 2(37.4%), TUG > 20 s (5.2%) or ASAIII-IV (48.8%). Major comorbidities (CACI > 6) were detected in 36%; 20.9% of patients had cognitive impairment according to Mini-Cog. Conclusion: The GOSAFE showed that frailty is frequent in older patients undergoing cancer surgery. QoL and FR, for the first time, are going to be primary outcomes of a real-life observational study. The crucial role of frailty assessment is going to be addressed in the ability to predict postoperative outcomes and to correlate with QoL and FR. (C) 2019 Elsevier Ltd. All rights reserved.

Published
2020

2. GOSAFE - Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery: early analysis on 977 patients

Author

Barbara Frezza, Giampaolo Castagnoli, Genoveffa Balducci, Valentina Riggio, G. Ugolini, Antonio Arroyo, Gianluca Garulli, Caterina Foppa, Kristin Cardin, Matthijs Plas, Gaetano Gallo, Francesca De Lucia, Francisco López-Rodríguez, Sandra Lario, Franco De Cian, Flavia Foca, Alberto Realis Luc, Paola Tramelli, Roberta Pellegrino, Giacomo Sermonesi, Stefano Sfondrini, Federico Ghignone, Orestis Ioannidis, Nicole M. Saur, Michael David Fejka, Basilio Pirrera, Bruno Alampi, Siri Rostoft, Sam Fox, Chiara Zingaretti, Ingeborg Flåten Backe, Alessandro Spaziani, Barbara Perenze, Minas Baltatzis, Riccardo A. Audisio, Claudia Santos, Luigi Marano, Mariann Lønn, Stefano Scabini, Andrea Massobrio, Patrizio Capelli, Isacco Montroni, Luis E. De León, Cristina Lillo, Alessio Lucarini, Valerio Belgrano, Antonino Spinelli, Daniela Di Pietrantonio, Nicola de Liguori Carino, Davide Pertile, Luigi Conti, Andrea Romboli, Giuseppe Sammarco, Hanoch Kashtan, Baha Siam, Michael T. Jaklitsch, Arild Nesbakken, Michele De Simone, Oriana Nanni, Filippo Banchini, Ajith K. Siriwardena, Giorgio Ercolani, Pietro Achilli, Davide Zattoni, Bernadette Vertogen, Steven D. Wexner, Laura Frain, Konstantinos Galanos-Demiris, Dario Maggioni, Baruch Brenner, Gerardo Palmieri, Giovanni Taffurelli, Barbara L. van Leeuwen, Manuela Albertelli, Gianluca Pellino, Anthony Chan, Alberto Bartoli, Emanuela Stratta, Mario Trompetto, Anna Garutti, Francesca Tauceri, Michele Mazzola, Beatrice Palermo, G. Clerico, Jakub Kenig, Yochai Levy, Graziana Barile, Vincenzo Alagna, Giulio Mari, Roberto Eggenhöffner, Joshua I. S. Bleier, Giovanni Ferrari, Andrea Costanzi, Michele Carvello, Francesca Di Candido, Francesco Monari, Ponnandai Somasundar, Kinga Szabat, Matteo Sacchi, Luis Sánchez-Guillén, Lydia Loutzidou, Lisa Cooper, Hanneke van der Wal-Huisman, Mariateresa Mirarchi, Domenico Soriero, Raffaele De Luca, Andrea Lucchi, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Clinical Cognitive Neuropsychiatry Research Program (CCNP), Montroni I., Rostoft S., Spinelli A., Van Leeuwen B.L., Ercolani G., Saur N.M., Jacklitsh M.T., Somasundar P.S., de Liguori Carino N., Ghignone F., Foca F., Zingaretti C., Audisio R.A., Ugolini G., Garutti A., Taffurelli G., Zattoni D., Tramelli P., Sermonesi G., Di Candido F., Carvello M., Sacchi M., De Lucia F., Foppa C., Plas M., Van der Wal-Huisman H., Tauceri F., Perenze B., Di Pietrantonio D., Mirarchi M., Fejka M., Bleier J.I.S., Frain L., Fox S.W., Cardin K., De Leon L.E., Baltatzis M., Chan A.K.C., Siriwardena A.K., Vertogen B., Nanni O., Garulli G., Alagna V., Pirrera B., Lucchi A., Monari F., Conti L., Capelli P., Romboli A., Palmieri G., Banchini F., Marano L., Spaziani A., Castagnoli G., Bartoli A., Trompetto M., Gallo G., Luc A.R., Clerico G., Sammarco G., De Luca R., Barile G., Simone M., Costanzi A., Mari G., Maggioni M., Pellegrino R., Riggio V., Kenig J., Szabat K., Scabini S., Pertile D., Stratta E., Massobrio A., Soriero D., Nesbakken A., Lonn M., Backe I.F., Ferrari G., Mazzola M., Alampi B.D.A., Achilli P., Sfondrini S., Ioannidis O., Loutzidou L., Galanos-Demiris K., Pellino G., Balducci G., Frezza B., Lucarini A., Santos C., Cooper L., Siam B., Levy Y., Brenner B., Kashtan H., Belgrano V., De Cian F., Palermo B., Eggenhoffner R., Albertelli M., Sanchez-Guillen L., Arroyo A., Lopez-Rodriguez F., Lario S., Lillo C., Wexner S.D., Montroni, I., Rostoft, S., Spinelli, A., Van Leeuwen, B. L., Ercolani, G., Saur, N. M., Jacklitsh, M. T., Somasundar, P. S., de Liguori Carino, N., Ghignone, F., Foca, F., Zingaretti, C., Audisio, R. A., Ugolini, G., Garutti, A., Taffurelli, G., Zattoni, D., Tramelli, P., Sermonesi, G., Di Candido, F., Carvello, M., Sacchi, M., De Lucia, F., Foppa, C., Plas, M., Van der Wal-Huisman, H., Tauceri, F., Perenze, B., Di Pietrantonio, D., Mirarchi, M., Fejka, M., Bleier, J. I. S., Frain, L., Fox, S. W., Cardin, K., De Leon, L. E., Baltatzis, M., Chan, A. K. C., Siriwardena, A. K., Vertogen, B., Nanni, O., Garulli, G., Alagna, V., Pirrera, B., Lucchi, A., Monari, F., Conti, L., Capelli, P., Romboli, A., Palmieri, G., Banchini, F., Marano, L., Spaziani, A., Castagnoli, G., Bartoli, A., Trompetto, M., Gallo, G., Luc, A. R., Clerico, G., Sammarco, G., De Luca, R., Barile, G., Simone, M., Costanzi, A., Mari, G., Maggioni, M., Pellegrino, R., Riggio, V., Kenig, J., Szabat, K., Scabini, S., Pertile, D., Stratta, E., Massobrio, A., Soriero, D., Nesbakken, A., Lonn, M., Backe, I. F., Ferrari, G., Mazzola, M., Alampi, B. D. A., Achilli, P., Sfondrini, S., Ioannidis, O., Loutzidou, L., Galanos-Demiris, K., Pellino, G., Balducci, G., Frezza, B., Lucarini, A., Santos, C., Cooper, L., Siam, B., Levy, Y., Brenner, B., Kashtan, H., Belgrano, V., De Cian, F., Palermo, B., Eggenhoffner, R., Albertelli, M., Sanchez-Guillen, L., Arroyo, A., Lopez-Rodriguez, F., Lario, S., Lillo, C., and Wexner, S. D.

Subjects
Geriatric Oncology, Surgical Assessment, Functional Recovery, Pre&postoperative testing, Surgery morbidity, Surgery mortality, Male, medicine.medical_specialty, Surgery morbidity, MEDLINE, MULTICENTER, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Pre&postoperative testing, Quality of life, aged, aged, 80 and over, female, geriatric assessment, humans, male, neoplasms, postoperative complications, prospective studies, quality of life, Functional Recovery, Internal medicine, Neoplasms, medicine, 80 and over, Humans, 030212 general & internal medicine, Prospective Studies, Elective surgery, Geriatric Assessment, cancer, geriatric, outcome, Aged, Aged, 80 and over, business.industry, Surgical Assessment, Cancer, Functional recovery, medicine.disease, CANCER, Geriatric Oncology, Surgery mortality, Oncology, Geriatric oncology, 030220 oncology & carcinogenesis, Quality of Life, Observational study, Female, Geriatrics and Gerontology, business, Early analysis
Abstract

Objective: Older patients with cancer value functional outcomes as much as survival, but surgical studies lack functional recovery (FR) data. The value of a standardized frailty assessment has been confirmed, yet it's infrequently utilized due to time restrictions into everyday practice. The multicenter GOSAFE study was designed to (1) evaluate the trajectory of patients' quality of life (QoL) after cancer surgery (2) assess baseline frailty indicators in unselected patients (3) clarify the most relevant tools in predicting FR and clinical outcomes. This is a report of the study design and baseline patient evaluations. Materials & Methods: GOSAFE prospectively collected a baseline multidimensional evaluation before major elective surgery in patients (≥70 years) from 26 international units. Short−/mid−/long-term surgical outcomes were recorded with QoL and FR data. Results: 1003 patients were enrolled in a 26-month span. Complete baseline data were available for 977(97.4%). Median age was 78 years (range 70–94); 52.8% males. 968(99%) lived at home, 51.6% without caregiver. 54.4% had ≥ 3 medications, 5.9% none. Patients were dependent (ADL < 5) in 7.9% of the cases. Frailty was either detected by G8 ≤ 14(68.4%), fTRST ≥ 2(37.4%), TUG > 20 s (5.2%) or ASAIII-IV (48.8%). Major comorbidities (CACI > 6) were detected in 36%; 20.9% of patients had cognitive impairment according to Mini-Cog. Conclusion: The GOSAFE showed that frailty is frequent in older patients undergoing cancer surgery. QoL and FR, for the first time, are going to be primary outcomes of a real-life observational study. The crucial role of frailty assessment is going to be addressed in the ability to predict postoperative outcomes and to correlate with QoL and FR.

Published
2019

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