Efficacy of geriatric multidisciplinary oncology clinic in surgical treatment decision-making process for frail elderly patients with colorectal cancer

Purpose: Multidisciplinary care has become a cornerstone of colorectal cancer management. To evaluate the clinical efficacy of a geriatric multidisciplinary oncology clinic (GMOC), we analyzed the surgical treatment decision-making process and outcomes. Methods: : Data of patients aged ≥65 years who participated in the GMOC at a tertiary referral hospital between 2015 and 2021 were reviewed. The clinical adherence rate, comprehensive geriatric assessment and a multidimensional frailty score (MFS) were obtained. The groups that were recommended and not recommended for surgery were compared, analyzing the factors impacting the decision and 1-year survival outcomes. Furthermore, the postoperative complications and 1-year survival outcomes of patients who underwent surgery were evaluated. Results: : A total of 165 patients visited the GMOC, and 74 had colorectal cancer (85.5 [81.2 – 89.0] years). Among patients with systemic disease (n=31), seven were recommended for surgery, and five actually underwent surgery. Among patients with locoregional disease (n=43), 18 were recommended for surgery, and 12 underwent surgery. Patients recommended and not recommended for surgery had significantly different activities of daily living (ADL) (p=0.024), instrumental ADL (p=0.001), Mini-Mental State Examination (p=0.014), delirium risk (p=0.039), and MFS (p=0.001). There was no difference in the 1-year overall survival between the two groups (p=0.980). Of the 17 patients who actually underwent surgery, the median operation time was 165.0 (120.0-270.0) min; hospital stay, 7.0 (6.0-8.0) days; and three patients had wound complications. Conclusion: Proper counseling of patients through the GMOC could lead to appropriate management and favorable outcomes.