Évaluation pluridisciplinaire préopératoire systématique en chirurgie cancérologique urologique gériatrique : faisabilité et résultats

Abstract

The incidence of cancer increases with age, especially for urological cancers. The frailty of the elderly persons may expose them to more postoperative complications resulting in prolonged hospitalization, increased morbidity or even increased mortality, and delayed or impossible return to normal life. In such cases, the benefit of surgery and therefore its realization can be questioned. This article reports the experience of a pre-operative risk assessment in a population of elderly patients treated for urologic cancer. This retrospective study aims to report the feasibility and the main results of this systematic preoperative multi-professional evaluation. Between April 2016and February 2017, 31elderly patients were evaluated. The evaluation revealed: moderate to severe malnutrition in 59% of cases, a patient judged from a geriatric point of view fit, intermediate or fragile in respectively 25%, 35% and 40% of cases. This evaluation led to propose a modification of an element of care for 66% of patients and to propose therapeutic abstention for only 3patients. An evaluation whose purpose is to adapt to the physiological age of patients and their overall state of health, surgical treatment and postoperative management is feasible and seems to help unmask elements of fragility usually not detected. 4.