Preoperative risk estimation for onco-geriatric patients (PREOP) – preoperative assessment of elderly surgical patients

Background

Most cancer patients undergoing surgery are aged ≥ 70, with 1/3 considered frail and at poor surgical risk.

Preoperative assessment of oncogeriatric patients may expand survival and improve quality of life.

Preoperative Assessment of Cancer in the Elderly (PACE) was useful in identifying those individuals with a poor surgical risk. Instrumental Activities of Daily Living (IADL), Brief Fatigue Inventory (BFI) and Performance Status (PS) correlate with operative 30-day mortality, while Activities of Daily Living (ADL), IADL and PS associate with a lengthy post-operative hospital stay.

PACE administration (Table 1) allows personalized oncological management but it's time-consuming (30 mins/pt). Newly developed screening tools might be as effective, but were never tested in a surgical scenario.

Table 1 Tools used in PREOP study vs. PACE study

Groningen Frailty Index (GFI), Vulnerable Elders Survey (VES-13) and the "up and go test" (Table 1) are quick tools, capable of identifying frail individuals.

PREOP is an international prospective investigation aiming to analyzing the predictive value of these new tools which are due to be compared against PACE.

Materials and methods

A prospective series of patients aged ≥ 70 years, undergoing elective cancer surgery will be recruited.

PACE, GFI, VES-13 and "up and go" will be pre-operatively administered. Pre-, peri- and post-operative data will be collected and entered into the database. 326 patients will need to be recruited within 2 years to allow analysis.