Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data from the International GOSAFE Study

Isacco Montroni; Giampaolo Ugolini; Nicole M. Saur; Siri Rostoft; Antonino Spinelli; Barbara L. Van Leeuwen; Nicola De Liguori Carino; Federico Ghignone; Michael T. Jaklitsch; Jakub Kenig; Anna Garutti; Chiara Zingaretti; Flavia Foca; Bernadette Vertogen; Oriana Nanni; Steven D. Wexner; Riccardo A. Audisio; Giovanni Taffurelli; Davide Zattoni; Paola Tramelli; Giacomo Sermonesi; Giorgio Ercolani; Francesca Tauceri; Barbara Perenze; Daniela Di Pietrantonio; Mariateresa Mirarchi; Gianluca Garulli; Vincenzo Alagna; Andrea Lucchi; Basilio Pirrera; Francesco Monari; Luigi Conti; Patrizio Capelli; Andrea Romboli; Gerardo Palmieri; Filippo Banchini; Francesca Di Candido; Michele Carvello; Matteo Sacchi; Francesca De Lucia; Caterina Foppa; Luigi Marano; Alessandro Spaziani; Giampaolo Castagnoli; Alberto Bartoli; Laura Frain; Sam W. Fox; Kristin Cardin; Luis E. De Leon; Mario Trompetto; Gaetano Gallo; Alberto Realis Luc; Giuseppe Clerico; Giuseppe Sammarco; Raffaele De Luca; Michele Simone; Anna Albano; Michael Fejka; Joshua I.S. Bleier; Matthijs Plas; Hanneke Van Der Wal-Huisman; Andrea Costanzi; Giulio Mari; Dario Maggioni; Roberta Pellegrino; Valentina Riggio; Kinga Szabat; Stefano Scabini; Davide Pertile; Lorenzo Epis; Andrea Massobrio; Domenico Soriero; Arild Nesbakken; Ingeborg Flåten Backe; Mariann Lønn; Giovanni Ferrari; Michele Mazzola; Carmelo Magistro; Pietro Achilli; Alessandro Giani; Orestis Ioannidis; Lydia Loutzidou; Konstantinos Galanos-Demiris; Gianluca Pellino; Genoveffa Balducci; Barbara Frezza; Alessio Lucarini; Claudia Santos; Lisa Cooper; Baha Siam; Yochai Levy; Baruch Brenner; Hanoch Kashtan; Valerio Belgrano; Franco Decian; Beatrice Palermo; Roberto Eggenhöffner; Manuela Albertelli; Luis Sánchez-Guillén; Antonio Arroyo; Francisco López-Rodríguez; Sandra Lario; Cristina Lillo; Minas Baltatzis; Anthony K.C. Chan; Ajith K. Siriwardena; Giovanna Da Silva

doi:10.1200/JCO.22.02195

Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data from the International GOSAFE Study

Isacco Montroni, Giampaolo Ugolini, Nicole M. Saur, Siri Rostoft, Antonino Spinelli, Barbara L. Van Leeuwen, Nicola De Liguori Carino, Federico Ghignone, Michael T. Jaklitsch, Jakub Kenig, Anna Garutti, Chiara Zingaretti, Flavia Foca^*, Bernadette Vertogen, Oriana Nanni, Steven D. Wexner, Riccardo A. Audisio, Giovanni Taffurelli, Davide Zattoni, Paola TramelliGiacomo Sermonesi, Giorgio Ercolani, Francesca Tauceri, Barbara Perenze, Daniela Di Pietrantonio, Mariateresa Mirarchi, Gianluca Garulli, Vincenzo Alagna, Andrea Lucchi, Basilio Pirrera, Francesco Monari, Luigi Conti, Patrizio Capelli, Andrea Romboli, Gerardo Palmieri, Filippo Banchini, Francesca Di Candido, Michele Carvello, Matteo Sacchi, Francesca De Lucia, Caterina Foppa, Luigi Marano, Alessandro Spaziani, Giampaolo Castagnoli, Alberto Bartoli, Laura Frain, Sam W. Fox, Kristin Cardin, Luis E. De Leon, Mario Trompetto, Gaetano Gallo, Alberto Realis Luc, Giuseppe Clerico, Giuseppe Sammarco, Raffaele De Luca, Michele Simone, Anna Albano, Michael Fejka, Joshua I.S. Bleier, Matthijs Plas, Hanneke Van Der Wal-Huisman, Andrea Costanzi, Giulio Mari, Dario Maggioni, Roberta Pellegrino, Valentina Riggio, Kinga Szabat, Stefano Scabini, Davide Pertile, Lorenzo Epis, Andrea Massobrio, Domenico Soriero, Arild Nesbakken, Ingeborg Flåten Backe, Mariann Lønn, Giovanni Ferrari, Michele Mazzola, Carmelo Magistro, Pietro Achilli, Alessandro Giani, Orestis Ioannidis, Lydia Loutzidou, Konstantinos Galanos-Demiris, Gianluca Pellino, Genoveffa Balducci, Barbara Frezza, Alessio Lucarini, Claudia Santos, Lisa Cooper, Baha Siam, Yochai Levy, Baruch Brenner, Hanoch Kashtan, Valerio Belgrano, Franco Decian, Beatrice Palermo, Roberto Eggenhöffner, Manuela Albertelli, Luis Sánchez-Guillén, Antonio Arroyo, Francisco López-Rodríguez, Sandra Lario, Cristina Lillo, Minas Baltatzis, Anthony K.C. Chan, Ajith K. Siriwardena, Giovanna Da Silva

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Abstract

PURPOSEThe GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.METHODSPatients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living ≥5 + Timed Up & Go test <20 seconds + MiniCog >2.RESULTSProspective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool ≥2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; P =.034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; P =.027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; P =.008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; P =.02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) ≥2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; P =.006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index ≥7 (OR, 2.59; 95% CI, 1.26 to 5.32; P =.009), ECOG ≥2 (OR, 3.12; 95% CI, 1.36 to 7.20; P =.007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; P =.009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; P <.001), fTRST ≥2 (OR, 2.71; 95% CI, 1.40 to 5.25; P =.003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; P =.017) are risk factors for not achieving FR.CONCLUSIONThe majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling.

Original language	English
Pages (from-to)	5247-5262
Number of pages	16
Journal	Journal of Clinical Oncology
Volume	41
Issue number	34
DOIs	https://doi.org/10.1200/JCO.22.02195
State	Published - 1 Dec 2023

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10.1200/JCO.22.02195

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Montroni, I., Ugolini, G., Saur, N. M., Rostoft, S., Spinelli, A., Van Leeuwen, B. L., De Liguori Carino, N., Ghignone, F., Jaklitsch, M. T., Kenig, J., Garutti, A., Zingaretti, C., Foca, F., Vertogen, B., Nanni, O., Wexner, S. D., Audisio, R. A., Taffurelli, G., Zattoni, D., ... Da Silva, G. (2023). Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data from the International GOSAFE Study. Journal of Clinical Oncology, 41(34), 5247-5262. https://doi.org/10.1200/JCO.22.02195

@article{905787995e5f4a41ba497fa1b1b7dbd2,

title = "Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data from the International GOSAFE Study",

abstract = "PURPOSEThe GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.METHODSPatients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living ≥5 + Timed Up & Go test <20 seconds + MiniCog >2.RESULTSProspective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool ≥2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; P =.034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; P =.027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; P =.008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; P =.02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) ≥2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; P =.006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index ≥7 (OR, 2.59; 95% CI, 1.26 to 5.32; P =.009), ECOG ≥2 (OR, 3.12; 95% CI, 1.36 to 7.20; P =.007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; P =.009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; P <.001), fTRST ≥2 (OR, 2.71; 95% CI, 1.40 to 5.25; P =.003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; P =.017) are risk factors for not achieving FR.CONCLUSIONThe majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling.",

author = "Isacco Montroni and Giampaolo Ugolini and Saur, {Nicole M.} and Siri Rostoft and Antonino Spinelli and {Van Leeuwen}, {Barbara L.} and {De Liguori Carino}, Nicola and Federico Ghignone and Jaklitsch, {Michael T.} and Jakub Kenig and Anna Garutti and Chiara Zingaretti and Flavia Foca and Bernadette Vertogen and Oriana Nanni and Wexner, {Steven D.} and Audisio, {Riccardo A.} and Giovanni Taffurelli and Davide Zattoni and Paola Tramelli and Giacomo Sermonesi and Giorgio Ercolani and Francesca Tauceri and Barbara Perenze and {Di Pietrantonio}, Daniela and Mariateresa Mirarchi and Gianluca Garulli and Vincenzo Alagna and Andrea Lucchi and Basilio Pirrera and Francesco Monari and Luigi Conti and Patrizio Capelli and Andrea Romboli and Gerardo Palmieri and Filippo Banchini and {Di Candido}, Francesca and Michele Carvello and Matteo Sacchi and {De Lucia}, Francesca and Caterina Foppa and Luigi Marano and Alessandro Spaziani and Giampaolo Castagnoli and Alberto Bartoli and Laura Frain and Fox, {Sam W.} and Kristin Cardin and {De Leon}, {Luis E.} and Mario Trompetto and Gaetano Gallo and {Realis Luc}, Alberto and Giuseppe Clerico and Giuseppe Sammarco and {De Luca}, Raffaele and Michele Simone and Anna Albano and Michael Fejka and Bleier, {Joshua I.S.} and Matthijs Plas and {Van Der Wal-Huisman}, Hanneke and Andrea Costanzi and Giulio Mari and Dario Maggioni and Roberta Pellegrino and Valentina Riggio and Kinga Szabat and Stefano Scabini and Davide Pertile and Lorenzo Epis and Andrea Massobrio and Domenico Soriero and Arild Nesbakken and {Fl{\aa}ten Backe}, Ingeborg and Mariann L{\o}nn and Giovanni Ferrari and Michele Mazzola and Carmelo Magistro and Pietro Achilli and Alessandro Giani and Orestis Ioannidis and Lydia Loutzidou and Konstantinos Galanos-Demiris and Gianluca Pellino and Genoveffa Balducci and Barbara Frezza and Alessio Lucarini and Claudia Santos and Lisa Cooper and Baha Siam and Yochai Levy and Baruch Brenner and Hanoch Kashtan and Valerio Belgrano and Franco Decian and Beatrice Palermo and Roberto Eggenh{\"o}ffner and Manuela Albertelli and Luis S{\'a}nchez-Guill{\'e}n and Antonio Arroyo and Francisco L{\'o}pez-Rodr{\'i}guez and Sandra Lario and Cristina Lillo and Minas Baltatzis and Chan, {Anthony K.C.} and Siriwardena, {Ajith K.} and {Da Silva}, Giovanna",

note = "Publisher Copyright: {\textcopyright} American Society of Clinical Oncology.",

year = "2023",

month = dec,

day = "1",

doi = "10.1200/JCO.22.02195",

language = "אנגלית",

volume = "41",

pages = "5247--5262",

journal = "Journal of Clinical Oncology",

issn = "0732-183X",

publisher = "American Society of Clinical Oncology",

number = "34",

}

Montroni, I, Ugolini, G, Saur, NM, Rostoft, S, Spinelli, A, Van Leeuwen, BL, De Liguori Carino, N, Ghignone, F, Jaklitsch, MT, Kenig, J, Garutti, A, Zingaretti, C, Foca, F, Vertogen, B, Nanni, O, Wexner, SD, Audisio, RA, Taffurelli, G, Zattoni, D, Tramelli, P, Sermonesi, G, Ercolani, G, Tauceri, F, Perenze, B, Di Pietrantonio, D, Mirarchi, M, Garulli, G, Alagna, V, Lucchi, A, Pirrera, B, Monari, F, Conti, L, Capelli, P, Romboli, A, Palmieri, G, Banchini, F, Di Candido, F, Carvello, M, Sacchi, M, De Lucia, F, Foppa, C, Marano, L, Spaziani, A, Castagnoli, G, Bartoli, A, Frain, L, Fox, SW, Cardin, K, De Leon, LE, Trompetto, M, Gallo, G, Realis Luc, A, Clerico, G, Sammarco, G, De Luca, R, Simone, M, Albano, A, Fejka, M, Bleier, JIS, Plas, M, Van Der Wal-Huisman, H, Costanzi, A, Mari, G, Maggioni, D, Pellegrino, R, Riggio, V, Szabat, K, Scabini, S, Pertile, D, Epis, L, Massobrio, A, Soriero, D, Nesbakken, A, Flåten Backe, I, Lønn, M, Ferrari, G, Mazzola, M, Magistro, C, Achilli, P, Giani, A, Ioannidis, O, Loutzidou, L, Galanos-Demiris, K, Pellino, G, Balducci, G, Frezza, B, Lucarini, A, Santos, C, Cooper, L, Siam, B, Levy, Y, Brenner, B , Kashtan, H, Belgrano, V, Decian, F, Palermo, B, Eggenhöffner, R, Albertelli, M, Sánchez-Guillén, L, Arroyo, A, López-Rodríguez, F, Lario, S, Lillo, C, Baltatzis, M, Chan, AKC, Siriwardena, AK & Da Silva, G 2023, 'Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data from the International GOSAFE Study', Journal of Clinical Oncology, vol. 41, no. 34, pp. 5247-5262. https://doi.org/10.1200/JCO.22.02195

TY - JOUR

T1 - Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery

T2 - Real-World Data from the International GOSAFE Study

AU - Montroni, Isacco

AU - Ugolini, Giampaolo

AU - Saur, Nicole M.

AU - Rostoft, Siri

AU - Spinelli, Antonino

AU - Van Leeuwen, Barbara L.

AU - De Liguori Carino, Nicola

AU - Ghignone, Federico

AU - Jaklitsch, Michael T.

AU - Kenig, Jakub

AU - Garutti, Anna

AU - Zingaretti, Chiara

AU - Foca, Flavia

AU - Vertogen, Bernadette

AU - Nanni, Oriana

AU - Wexner, Steven D.

AU - Audisio, Riccardo A.

AU - Taffurelli, Giovanni

AU - Zattoni, Davide

AU - Tramelli, Paola

AU - Sermonesi, Giacomo

AU - Ercolani, Giorgio

AU - Tauceri, Francesca

AU - Perenze, Barbara

AU - Di Pietrantonio, Daniela

AU - Mirarchi, Mariateresa

AU - Garulli, Gianluca

AU - Alagna, Vincenzo

AU - Lucchi, Andrea

AU - Pirrera, Basilio

AU - Monari, Francesco

AU - Conti, Luigi

AU - Capelli, Patrizio

AU - Romboli, Andrea

AU - Palmieri, Gerardo

AU - Banchini, Filippo

AU - Di Candido, Francesca

AU - Carvello, Michele

AU - Sacchi, Matteo

AU - De Lucia, Francesca

AU - Foppa, Caterina

AU - Marano, Luigi

AU - Spaziani, Alessandro

AU - Castagnoli, Giampaolo

AU - Bartoli, Alberto

AU - Frain, Laura

AU - Fox, Sam W.

AU - Cardin, Kristin

AU - De Leon, Luis E.

AU - Trompetto, Mario

AU - Gallo, Gaetano

AU - Realis Luc, Alberto

AU - Clerico, Giuseppe

AU - Sammarco, Giuseppe

AU - De Luca, Raffaele

AU - Simone, Michele

AU - Albano, Anna

AU - Fejka, Michael

AU - Bleier, Joshua I.S.

AU - Plas, Matthijs

AU - Van Der Wal-Huisman, Hanneke

AU - Costanzi, Andrea

AU - Mari, Giulio

AU - Maggioni, Dario

AU - Pellegrino, Roberta

AU - Riggio, Valentina

AU - Szabat, Kinga

AU - Scabini, Stefano

AU - Pertile, Davide

AU - Epis, Lorenzo

AU - Massobrio, Andrea

AU - Soriero, Domenico

AU - Nesbakken, Arild

AU - Flåten Backe, Ingeborg

AU - Lønn, Mariann

AU - Ferrari, Giovanni

AU - Mazzola, Michele

AU - Magistro, Carmelo

AU - Achilli, Pietro

AU - Giani, Alessandro

AU - Ioannidis, Orestis

AU - Loutzidou, Lydia

AU - Galanos-Demiris, Konstantinos

AU - Pellino, Gianluca

AU - Balducci, Genoveffa

AU - Frezza, Barbara

AU - Lucarini, Alessio

AU - Santos, Claudia

AU - Cooper, Lisa

AU - Siam, Baha

AU - Levy, Yochai

AU - Brenner, Baruch

AU - Kashtan, Hanoch

AU - Belgrano, Valerio

AU - Decian, Franco

AU - Palermo, Beatrice

AU - Eggenhöffner, Roberto

AU - Albertelli, Manuela

AU - Sánchez-Guillén, Luis

AU - Arroyo, Antonio

AU - López-Rodríguez, Francisco

AU - Lario, Sandra

AU - Lillo, Cristina

AU - Baltatzis, Minas

AU - Chan, Anthony K.C.

AU - Siriwardena, Ajith K.

AU - Da Silva, Giovanna

PY - 2023/12/1

Y1 - 2023/12/1

N2 - PURPOSEThe GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.METHODSPatients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living ≥5 + Timed Up & Go test <20 seconds + MiniCog >2.RESULTSProspective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool ≥2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; P =.034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; P =.027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; P =.008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; P =.02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) ≥2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; P =.006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index ≥7 (OR, 2.59; 95% CI, 1.26 to 5.32; P =.009), ECOG ≥2 (OR, 3.12; 95% CI, 1.36 to 7.20; P =.007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; P =.009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; P <.001), fTRST ≥2 (OR, 2.71; 95% CI, 1.40 to 5.25; P =.003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; P =.017) are risk factors for not achieving FR.CONCLUSIONThe majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling.

AB - PURPOSEThe GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.METHODSPatients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living ≥5 + Timed Up & Go test <20 seconds + MiniCog >2.RESULTSProspective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool ≥2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; P =.034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; P =.027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; P =.008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; P =.02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) ≥2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; P =.006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index ≥7 (OR, 2.59; 95% CI, 1.26 to 5.32; P =.009), ECOG ≥2 (OR, 3.12; 95% CI, 1.36 to 7.20; P =.007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; P =.009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; P <.001), fTRST ≥2 (OR, 2.71; 95% CI, 1.40 to 5.25; P =.003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; P =.017) are risk factors for not achieving FR.CONCLUSIONThe majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling.

UR - http://www.scopus.com/inward/record.url?scp=85166978183&partnerID=8YFLogxK

U2 - 10.1200/JCO.22.02195

DO - 10.1200/JCO.22.02195

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

C2 - 37390383

AN - SCOPUS:85166978183

SN - 0732-183X

VL - 41

SP - 5247

EP - 5262

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 34

ER -

Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data from the International GOSAFE Study

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