ArticleJournal of the National Cancer Institute2022
Quality of Life in Older Adults After Major Cancer Surgery: The GOSAFE International Study.
Article in Journal of the National Cancer Institute, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Changes in quality of life throughout the illness trajectory of older adults with cancer: a systematic review.The oncologist · 2025Pooled it
- Exploring the role of health-related quality of life measures in predictive modelling for oncology: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Pooled it
- Navigating long-term patient-reported outcomes after colorectal cancer surgery in older adults: ostomy, nutritional status, and living conditions as determinants in a prospective cohort study.International journal of colorectal disease · 2026Observational
- Unlocking bone repair in osteoporosis by targeting the angiogenic niche.Frontiers in endocrinology · 2026Review
- What matters to patients with cancer receiving home care at the end of life? A qualitative study comparing patients' and healthcare professionals' views.International journal of qualitative studies on health and well-being · 2025Article
- Understanding frailty and the role of patient-centered care for older adults with gynecologic cancer.Gynecologic oncology · 2025Review
- The pervasive impact of frailty on ovarian cancer care and the role of prehabilitation: Qualitative perspectives of key stakeholders.Journal of geriatric oncology · 2025Article
- Recovery trajectories after major abdominal surgery: A retrospective pooled cohort study.Acta anaesthesiologica Scandinavica · 2025Article
- Comparison of Modified Frailty Index, Clinical Frailty Scale, ECOG Score, and ASA PS Score in Predicting Postoperative Outcomes in Cancer Surgery: A Prospective Study.Indian journal of surgical oncology · 2024Article
- The Aging Stomach: Clinical Implications ofInternational journal of molecular sciences · 2024Review
- Review
- Assessing the mFI-5 frailty score and functional status in geriatric patients undergoing inguinal hernia repairs.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Prospective, Multi-Institutional Observational Study of Deterioration in Activities of Daily Living in Elderly Patients After Lung Cancer Surgery.JTO clinical and research reports · 2023Article
- Minimally Invasive Surgery for Perihilar Cholangiocarcinoma: A Systematic Review of the Short- and Long-Term Results.Cancers · 2023Review
- Health-related quality-of-life trajectories during/after surgery and adjuvant chemotherapy in patients with colon cancer.European geriatric medicine · 2023Article
- Comparison of changes in health-related quality of life between elderly and non-elderly patients undergoing elective surgery for colorectal cancer.International journal of colorectal disease · 2023Article
- Frailty Assessment and Prehabilitation as Part of a PeRioperative Evaluation and Planning (PREP) Program for Patients Undergoing Colorectal Surgery.Clinics in colon and rectal surgery · 2023Review
- It is not "If" but "How" Preoperative Frailty Assessment Should be Provided.Annals of surgical oncology · 2023Article
- Frailty and Cancer: Current Perspectives on Assessment and Monitoring.Clinical interventions in aging · 2023Review
- Surgical Care for Older Adults: The Importance of Patient-Centered Outcomes in Daily Practice.Journal of the National Cancer Institute · 2022Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
18 authors at 11 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate quality of life (QoL) data and functional results after cancer surgery are lacking for older patients. The international, multicenter Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery (GOSAFE) Study compares QoL before and after surgery and identifies predictors of decline in QoL.
methodsGOSAFE prospectively collected data before and after major elective cancer surgery on older adults (≥70 years). Frailty assessment was performed and postoperative outcomes recorded (30, 90, and 180 days postoperatively) together with QoL data by means of the three-level version of the EuroQol five-dimensional questionnaire (EQ-5D-3L), including 2 components: an index (range = 0-1) generated by 5 domains (mobility, self-care, ability to perform the usual activities, pain or discomfort, anxiety or depression) and a visual analog scale.
resultsData from 26 centers were collected (February 2017-March 2019). Complete data were available for 942/1005 consecutive patients (94.0%): 492 male (52.2%), median age 78 years (range = 70-95 years), and primary tumor was colorectal in 67.8%. A total 61.2% of all surgeries were via a minimally invasive approach. The 30-, 90-, and 180-day mortality was 3.7%, 6.3%, and 9%, respectively. At 30 and 180 days, postoperative morbidity was 39.2% and 52.4%, respectively, and Clavien-Dindo III-IV complications were 13.5% and 18.7%, respectively. The mean EQ-5D-3L index was similar before vs 3 months but improved at 6 months (0.79 vs 0.82; P < .001). Domains showing improvement were pain and anxiety or depression. A Flemish Triage Risk Screening Tool score greater than or equal to 2 (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.13 to 2.21, P = .007), palliative surgery (OR = 2.14, 95% CI = 1.01 to 4.52, P = .046), postoperative complications (OR = 1.95, 95% CI = 1.19 to 3.18, P = .007) correlated with worsening QoL.
conclusionsGOSAFE shows that older adults' preoperative QoL is preserved 3 months after cancer surgery, independent of their age. Frailty screening tools, patient-reported outcomes, and goals-of-care discussions can guide decisions to pursue surgery and direct patients' expectations.
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