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World J Gastrointest Surg. 2015 Oct 27;7(10):223-5. doi: 10.4240/wjgs.v7.i10.223.

Way forward: Geriatric frailty assessment as risk predictor in gastric cancer surgery.

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Juul JW Tegels, Jan HMB Stoot, Department of Surgery, Zuyderland Medical Centre, 6130 MB Sittard, The Netherlands.


In gastric cancer patients chronological and biological age might vary greatly between patients. Age as well as American Society of Anaesthesiologists-physical status classifications are very non-specific and do not adequately predict adverse outcome. Improvements have been made such as the introduction of Charlson Comorbidity Index. Geriatric frailty is probably a better measure for patients resistance to stressors and physiological reserves. An increasing amount of evidence shows that geriatric frailty is a better predictor for adverse outcome after surgery, including gastric cancer surgery. Geriatric frailty can be assessed in a number of ways. Questionnaires such as the Groningen Frailty Indicator provide an easy and low cost method for gauging the presence of frailty in gastric cancer patients. This can then be used to provide a better preoperative risk assessment in these patients and improve decision making.


Gastric cancer; Geriatric frailty; Surgery

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