title: Peri-Operative Management of Older Adults with Cancer-The Roles of the Surgeon and Geriatrician.
abstract: Optimal surgical management of older adults with cancer starts pre-operatively. The surgeon plays a key role in the appropriate selection of patients and procedures, optimisation of their functional status prior to surgery, and provision of more intensive care for those who are at high risk of post-operative complications. The literature, mainly based on retrospective, non-randomised studies, suggests that factors such as age, co-morbidities, pre-operative cognitive function and intensity of the surgical procedure all appear to contribute to the development of post-operative complications. Several studies have shown that a pre-operative geriatric assessment predicts post-operative mortality and morbidity as well as survival in older surgical cancer patients. Geriatricians are used to working in multidisciplinary teams that assess older patients and make individual treatment plans. However, the role of the geriatrician in the surgical oncology setting is not well established. A geriatrician could be a valuable contribution to the treatment team both in the pre-operative stage (patient assessment and pre-operative optimisation) and the post-operative stage (patient assessment and treatment of medical complications as well as discharge planning).
authors: School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE 22 3DT, UK. ruth.parks@nhs.net.
authors: Ruth Mary
authors: RM
authors: Parks
authors: Department of Geriatric Medicine, Oslo University Hospital, Oslo 0424, Norway. srostoft@gmail.com.
authors: Siri
authors: S
authors: Rostoft
authors: Department of Geriatric Medicine, Akershus University Hospital, Po box 1000, Lørenskog 1478, Norway. ninaommundsen@gmail.com.
authors: Nina
authors: N
authors: Ommundsen
authors: School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby DE 22 3DT, UK. kl.cheung@nottingham.ac.uk.
authors: Kwok-Leung
authors: KL
authors: Cheung
keywords: cancer in the older adult; comprehensive geriatric assessment; geriatrician; multidisciplinary team; surgeon