The Critical Evolution of the Concept of Frailty in Surgery

Tsoulfas, Georgios

doi:10.1245/s10434-023-14529-6

Cited by 1 publication

(2 citation statements)

References 13 publications

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“…Another interesting concept is frailty, a multidimensional syndrome often accompanied by malnutrition and sarcopenia, which represents decreased physiologic reserve and ability to recover from different stressors [69]. Frailty is a dynamic state that mirrors biological age, influenced by conditions such as comorbidities or social determinants of health.…”

Section: Nutritionmentioning

confidence: 99%

“…Frail GC patients are at significantly higher risk of mortality (6.83 vs. 3.50%), morbidity (3.42 vs. 0.94%), and prolonged length of stay (16.7 vs. 12.0 days) when compared with non-frail individuals [70]. While the concept is promising, the National Surgical Quality Improvement Program (NSQIP), established by the American College of Surgeons, has emphasized the need for additional efforts in defining and assessing frailty [69,71].…”

Section: Nutritionmentioning

confidence: 99%

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Textbook Neoadjuvant Outcome—Novel Composite Measure of Oncological Outcomes among Gastric Cancer Patients Undergoing Multimodal Treatment

Pelc,

Sędłak,

Leśniewska

et al. 2024

Cancers

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The incidence of gastric cancer (GC) is expected to increase to 1.77 million cases by 2040. To improve treatment outcomes, GC patients are increasingly treated with neoadjuvant chemotherapy (NAC) prior to curative-intent resection. Although NAC enhances locoregional control and comprehensive patient care, survival rates remain poor, and further investigations should establish outcomes assessment of current clinical pathways. Individually assessed parameters have served as benchmarks for treatment quality in the past decades. The Outcome4Medicine Consensus Conference underscores the inadequacy of isolated metrics, leading to increased recognition and adoption of composite measures. One of the most simple and comprehensive is the “All or None” method, which refers to an approach where a specific set of criteria must be fulfilled for an individual to achieve the overall measure. This narrative review aims to present the rationale for the implementation of a novel composite measure, Textbook Neoadjuvant Outcome (TNO). TNO integrates five objective and well-established components: Treatment Toxicity, Laboratory Tests, Imaging, Time to Surgery, and Nutrition. It represents a desired, multidisciplinary care and hospitalization of GC patients undergoing NAC to identify the treatment- and patient-related data required to establish high-quality oncological care further. A key strength of this narrative review is the clinical feasibility and research background supporting the implementation of the first and novel composite measure representing the “ideal” and holistic care among patients with locally advanced esophago-gastric junction (EGJ) and GC in the preoperative period after NAC. Further analysis will correlate clinical outcomes with the prognostic factors evaluated within the TNO framework.

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Section: Nutritionmentioning

confidence: 99%