Cachexia and Postoperative Outcomes in Elderly Patients with Gastrointestinal Cancer

Abstract

AbstractCachexia is a multifactorial syndrome that is common in patients with cancer. In particular, gastrointestinal cancer and elderly cancer patients have a high prevalence of cachexia. Although several definitions of cancer cachexia have been developed, such as the international consensus of the European Palliative Care Research Collaborative, the definitions used for each clinical trial are not unified. Additionally, the assessments and treatment for cancer cachexia vary greatly. Cancer cachexia adversely affects mortality and morbidity, physical function, and the quality of life of patients. Cancer cachexia is present not only in the terminal stage but also in the perioperative period. Moreover, preoperative cancer cachexia can negatively affect postoperative outcomes. One treatment for gastrointestinal cancer is surgery, and an enhanced recovery after surgery protocol and prehabilitation are important for promoting recovery in patients. Since cancer cachexia is a multifactorial syndrome, multimodal interventions, including nutritional, pharmacological, or other interventions, including exercise, are important. There are some trials on the management of cancer cachexia. However, the available evidence is insufficient. Physical therapy as part of multimodal interventions can be a potentially effective management for patients with cancer cachexia and may lead to improved postoperative outcomes. Further research is needed to accumulate further evidence.KeywordsCancer cachexiaPostoperative outcomesGastrointestinal cancerElderly patientsEnhanced recovery after surgeryPrehabilitationMultimodal interventions