TY - JOUR
T1 - GOSAFE - Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery
T2 - early analysis on 977 patients
AU - SIOG Surgical Task Force
AU - ESSO GOSAFE Study Grp
AU - Montroni, Isacco
AU - Rostoft, Siri
AU - Spinelli, Antonino
AU - Van Leeuwen, Barbara L.
AU - Ercolani, Giorgio
AU - Saur, Nicole M.
AU - Jaklitsch, Michael T.
AU - Somasundar, Ponnandai S.
AU - Carino, Nicola de Liguori
AU - Ghignone, Federico
AU - Foca, Flavia
AU - Zingaretti, Chiara
AU - Audisio, Riccardo A.
AU - Ugolini, Giampaolo
AU - Garutti, Anna
AU - Taffurelli, Giovanni
AU - Zattoni, Davide
AU - Tramelli, Paola
AU - Sermonesi, Giacomo
AU - Di Candido, Francesca
AU - Carvello, Michele
AU - Sacchi, Matteo
AU - De Lucia, Francesca
AU - Foppa, Caterina
AU - Plas, Matthijs
AU - Van der Wal-Huisman, Hanneke
AU - Tauceri, Francesca
AU - Perenze, Barbara
AU - Di Pietrantonio, Daniela
AU - Mirarchi, Mariateresa
AU - Fejka, Michael
AU - Bleier, Joshua I. S.
AU - Frain, Laura
AU - Fox, Sam W.
AU - Cardin, Kristin
AU - De Leon, Luis E.
AU - Baltatzis, Minas
AU - Chan, Anthony K. C.
AU - Siriwardena, Ajith K.
AU - Vertogen, Bernadette
AU - Nanni, Oriana
AU - Garulli, Gianluca
AU - Alagna, Vincenzo
AU - Pirrera, Basilio
AU - Lucchi, Andrea
AU - Monari, Francesco
AU - Conti, Luigi
AU - Capelli, Patrizio
AU - Romboli, Andrea
AU - Lucarini, Alessio
PY - 2020/3
Y1 - 2020/3
N2 - 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.
AB - 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.
KW - CANCER
KW - MULTICENTER
U2 - 10.1016/j.jgo.2019.06.017
DO - 10.1016/j.jgo.2019.06.017
M3 - Article
SN - 1879-4068
VL - 11
SP - 244
EP - 255
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 2
ER -