273 Outcomes Reported in Elective Colorectal Cancer Surgery Research for Older Patients: A Scoping Review

Abstract

Abstract Aim This scoping review aimed to identify outcome measures for assessing the impact of elective colorectal cancer surgery on older patients, given their higher surgical risk and mortality rates. Conventional surgery-specific outcomes, like 5-year mortality rates, may not be appropriate, necessitating a focus on postoperative quality of life. The challenge lies in determining optimal outcomes to assess the effects of colorectal cancer resections in the older population. Method A comprehensive literature search of major electronic databases from inception to March 2023 was conducted. Studies exploring frail or elderly individuals with colorectal cancer undergoing elective surgery and reporting postoperative outcomes were included. Outcomes were classified as surgery-specific versus person-centred and summarised using a 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 of the 16 ‘person-centred outcome’ studies reported discharge destination, with home discharge being predominant. Postoperative delirium ranged from 8.2% to 18.1% in six studies. Four studies explored geriatric syndromes and three analysed activities of daily living. Three studies reported a significant improvement in quality of life. The 66 ‘surgery-specific 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). Conclusions Person-centred outcomes are underreported, despite their importance in guiding patient management. Older patients require adequate information about their recovery after surgery to manage their lives better. Future research must address this gap to improve care for older patients undergoing elective colorectal cancer surgery.