Surgical Oncology in the Elderly: The State of the Art and Future Challenges - Vol. II

About this Research Topic

Background

Given the success of the Research Topic "Surgical Oncology in the Elderly: The State of the Art and Future Challenges", we are delighted to announce the launch of a second volume.

Population ageing is occurring throughout the world. Globally, the number of persons aged 80 years or over is projected to increase more than threefold between 2017 and 2050, rising from 137 million to 425 million. With this increase in age, cancer will become a more prevalent condition and with it, the number of elderly patients in need of a surgical evaluation. Surgical oncology in the elderly poses several challenges. The progressive functional inadequacy of physiological systems has a significant impact in the perioperative management of cancer patients, as well as the tolerance to oncological treatments, i.e. chemotherapy, radiotherapy, major curative surgery. Furthermore, despite the increasing number of elderly patients with cancer, there is a lack of evidence-based knowledge on this topic, since only a small sub-setting of geriatric patients have been included into clinical trials.

The surgical management of elderly patients with cancer is still an open challenge for the surgical oncologist. Currently, there is great interest in the preoperative assessment of these patients. In particular there is a need for prognostic factors that could act as indicators of frailty, giving the clinician the ability to guide the clinical decision making further. Furthermore, the influence of age on postoperative outcomes is a matter of debate: while some studies have shown age as an independent prognostic factor for postoperative morbidity and mortality, other Authors have suggested that healthy elderly patients can undergo surgical oncologic resection, experiencing similar results as younger patients. Similarly, the feasibility of multimodality therapy (preoperative chemotherapy or preoperative chemotherapy plus radiation) remains unclear, and the benefit of such a therapeutic approach in the elderly has not been fully clarified. Elderly patients are more susceptible to the toxicities of certain chemotherapy and radiation therapy regimens, and there are concerns regarding the possible increase of postoperative morbidity after neoadjuvant treatments. Finally, minimally invasive surgical resections (both laparoscopic and robotic) have been introduced for many malignancies. However, their role in the geriatric patients remains to be assessed.

This Research Topic will focus on the surgical management of esophago-gastric, pancreatic and colorectal neoplasms in elderly patients. In particular, it will address the following themes:

- The preoperative work-up
- The role of prognostic factors and indicators of frailty
- The influence of age on short and long-term surgical outcomes
- The use of multimodal approaches and their impact on the surgical results
- The role of minimally invasive approaches

We are inviting relevant original research, systematic reviews, meta-analyses, and short communications covering the above-mentioned topics.

Important Note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.

Keywords: Elderly, Surgical oncology, Cancer, Geriatric, Medicine, Surgery

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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