Abstract
Background
Colorectal cancer rates are increasing in older populations, who often have co-morbidities and face higher surgical risks and mortality rates. Therefore, surgical outcomes, such as 5-year mortality rates, may not be appropriate, necessitating a focus on postoperative quality of life. However, determining optimal postoperative outcome measures for older colorectal cancer patients poses a challenge. This scoping review aimed to explore currently available data describing post-operative outcomes used to assess older patients undergoing elective colorectal cancer surgery.
Methods
We conducted a comprehensive literature search of major electronic databases from inception to March 2023. Studies exploring frail or older individuals with colorectal cancer undergoing elective surgical procedures, reporting postoperative outcomes, were included. Outcomes were categorised as surgery-specific versus person-centred and summarised using narrative synthesis. The type and rate of surgery-specific outcomes were tabulated.
Results
Of 1366 identified citations, 16 studies focused on person-centred outcomes and 66 exclusively on surgery-specific outcomes. Nine ‘person-centred outcome’ studies reported discharge destination, primarily home discharge. Postoperative delirium ranged from 8.2% to 18.1% in six studies. Four studies explored geriatric syndromes, three analysed activities of daily living, and three studies reported significant quality of life improvement. The 66 ‘surgeryspecific outcome’ studies assessed mortality (N=61); length of stay (N=40); postoperative complications (N=47); readmission (N=18); reoperation (N=16); and survival (N=42). 2
Conclusion
Person-centred outcomes are underreported, but crucial for guiding patient management. Older patients require adequate information about their postoperative recovery period to enhance wellbeing. Future research must address this gap to improve care for older people undergoing elective colorectal cancer surgery
Colorectal cancer rates are increasing in older populations, who often have co-morbidities and face higher surgical risks and mortality rates. Therefore, surgical outcomes, such as 5-year mortality rates, may not be appropriate, necessitating a focus on postoperative quality of life. However, determining optimal postoperative outcome measures for older colorectal cancer patients poses a challenge. This scoping review aimed to explore currently available data describing post-operative outcomes used to assess older patients undergoing elective colorectal cancer surgery.
Methods
We conducted a comprehensive literature search of major electronic databases from inception to March 2023. Studies exploring frail or older individuals with colorectal cancer undergoing elective surgical procedures, reporting postoperative outcomes, were included. Outcomes were categorised as surgery-specific versus person-centred and summarised using narrative synthesis. The type and rate of surgery-specific outcomes were tabulated.
Results
Of 1366 identified citations, 16 studies focused on person-centred outcomes and 66 exclusively on surgery-specific outcomes. Nine ‘person-centred outcome’ studies reported discharge destination, primarily home discharge. Postoperative delirium ranged from 8.2% to 18.1% in six studies. Four studies explored geriatric syndromes, three analysed activities of daily living, and three studies reported significant quality of life improvement. The 66 ‘surgeryspecific outcome’ studies assessed mortality (N=61); length of stay (N=40); postoperative complications (N=47); readmission (N=18); reoperation (N=16); and survival (N=42). 2
Conclusion
Person-centred outcomes are underreported, but crucial for guiding patient management. Older patients require adequate information about their postoperative recovery period to enhance wellbeing. Future research must address this gap to improve care for older people undergoing elective colorectal cancer surgery
| Original language | English |
|---|---|
| Pages (from-to) | 1871-1882 |
| Number of pages | 12 |
| Journal | Colorectal Disease |
| Volume | 26 |
| Issue number | 11 |
| Early online date | 4 Oct 2024 |
| DOIs | |
| Publication status | Published - Nov 2024 |
Bibliographical note
ACKNOWLEDGMENTSWe extend our gratitude to Professor Phyo Kyaw Myint for his invaluable advice and guidance
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.Keywords
- colorectal cancer
- elderly
- geriatric
- outcomes
- postoperative recovery
Access to Document
- Xavier_etal_CD_Outcomes_reported_in_VoR
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