Addressing surgical care needs of older cancer patients: 6 study notes

To address the needs of older adult patients undergoing cancer surgery, the American College of Surgeons developed a Geriatric Surgery Verification program. Implementing the program's guidelines resulted in a 72% lower risk of increased postoperative care needs, according to a Dec. 10 study published in the Journal of the American College of Surgeons.

The verification guidelines include a presurgical assessment of patients 65 and older that "captures factors overlooked in a standard history and physical exam," the study said.

Researchers from Providence, R.I.-based Roger Williams Medical Center and Boston University Medical Center analyzed the effects guideline implementation had on patient outcomes for older adults undergoing major abdominal cancer surgeries that required an inpatient stay of two days or more. 

Here are six notes from the study:

1. The control group consisted of 57 patients treated between January and December 2021, before the guidelines were implemented. The intervention group consisted of 43 patients treated between January and December 2022, after the guidelines were implemented. Both groups were evenly matched for clinical and sociodemographic characteristics.
   
   
2. The major abdominal cancer surgeries included in the study were foregut, hepatobiliary, pancreatic, colorectal, cytoreductive surgery, intra-abdominal sarcomas and gynecological.
   
   
3. To measure patients' loss of independence after surgery, the researchers analyzed postoperative institutionalization and changes to the patient's primary residence.
   
   
4. Use of the Geriatic Surgery Verification program guidelines was associated with shorter length of stay (4.4 days versus 6.5 days) and the increased likelihood of a patient being discharged to their home versus another medical institution (7.3% versus 24.1%).
   
   
5. Both groups had similar rates of ICU admission, in-hospital delirium, 30-day ED visits and 30-day mortality.
   
   
6. The intervention group saw a higher rate of surgical complications, though the study authors noted this rate was related to minor complications and did not significantly affect the intervention groups' 72% lower risk of increased postoperative care needs.
   
   "Further studies to explore different mechanisms within Geriatric Surgery Verification that lead to improved outcomes in geriatric oncologic population will be informative," the study authors wrote.