Abstract

Age is a powerful risk factor for development of colorectal cancer but is not a contraindication for surgery, although this surgery is characterised by poor outcomes, increasing morbidity and mortality. Contributing factors include their poor nutritional status, pre-existing comorbidity, polypharmacy, psychosocial issues, delayed diagnoses and frailty. To improve morbidity and mortality, several aspects of care need to be addressed. These include accurate and timely preoperative assessment to identify treatable pathology and, where possible, to consider and correct age specific disease processes. Identification of patients in whom treatment would be futile or associated with high risk is needed to avoid unnecessary interventions and to give patients realistic expectations. Therefore, by the creation of a multidisciplinary approach, where surgeons work side by side with anesthesiologists, geriatricians, physiotherapists, nutritionists and other professionals, can provide favourable surgical outcomes, through improved selection of candidates for intervention and a more considered exclusion of patients characterized by high risk profiles or a poor prognosis.

Keywords: Aging population; Frailty; Risk assessment

Abbreviations: CRC: Colorectal Cancer; APR: Abdomino Perianal Resection; LAR: Low Anterior Resection; TUG: Time Up and Go; ADLs: Activities of Daily Living; QoL: Quality of Life