Page 171 - Risk quantification and modification in older patients with colorectal cancer

Oncogeriatric care and Health Related Quality of Life
Our results suggest that one point difference in the Barthel Index can discriminate between groups of older patients that experience a difference in HRQoL before and after surgery. It underlines the importance of functional dependency in the investigation of HRQoL in older patients. Furthermore, we already know that age is not a useful selection tool for oncologic treatment and in older patients, other geriatric factors should be taken into account in the process of shared decision making.47 We add to this field that mild to moderate functional dependency, although a low baseline quality of life suggests otherwise, should not be considered a generic reason for withholding surgical treatment to older patients with CRC. Whether oncogeriatric care itself limits the impact of surgery or even improves HRQoL, should be further investigated.
Conclusions
Our study showed that in older functional dependent patients with CRC, colorectal surgery embedded in oncogeriatric care has a positive impact on HRQoL. Functionally dependent patients with CRC who survived the first three months after surgery reported significantly and clinically relevant better HRQoL compared to before surgery, although dependency persisted. This is important information that has to be taken into account in the decision-making process of older patients with CRC.
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