Activities of daily living and quality of life of elderly patients after elective surgery for gastric and colorectal cancers.
OBJECTIVE
To establish reliable standards for surgical application to elderly patients 75 years old or older with gastric or colorectal cancer with special reference to the postoperative recovery of activities of daily living (ADL) and quality of life (QOL).


BACKGROUND
ADL and QOL are important outcomes of surgery for the elderly. However, there has been only limited evidence on the natural course of recovery of functional independence.


METHODS
Two hundred twenty-three patients 75 years old or older with gastric or colorectal cancer were prospectively examined. Physical conditions, ADL, and QOL were evaluated preoperatively and at the first, third, and sixth postoperative month.


RESULTS
The mortality and morbidity rates were 0.4% and 28%, respectively. Twenty-four percent of patients showed a decrease in ADL at 1 month postoperatively, but most patients recovered from this transient reduction, with only 3% showing a decline at the sixth postoperative month (6POM). ADL of these patients was likely to decrease after discharge from the hospital. QOL of the patients showed a recovery to an extent equal to or better than their average preoperative scores.


CONCLUSIONS
Of the patients 75 years old or older who underwent elective surgery for gastric or colorectal cancer, only a few showed a protracted decline in ADL and most exhibited better QOL after surgery. This indicates that surgical treatment should be considered, whenever needed, for elderly patients 75 years old or older with gastric or colorectal cancer. Estimation of Physical Ability and Surgical Stress is useful for predicting postoperative declines in ADL and protracted disability; this could aid in establishing a directed rehabilitation program for preventing protracted disability in elderly patients.
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Takeshi
T
Amemiya
Koji
K
Oda
Masahiko
M
Ando
Takashi
T
Kawamura
Yuichi
Y
Kitagawa
Yayoi
Y
Okawa
Akihiro
A
Yasui
Hideyuki
H
Ike
Hiroshi
H
Shimada
Kojiro
K
Kuroiwa
Yuji
Y
Nimura
Shinji
S
Fukata
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009017:Morbidity; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome