IDDF2020-ABS-0111 Does frailty predict postoperative outcomes in geriatric patients receiving surgery for colorectal cancer? A systematic review and meta-analysis

Background Surgery remains the mainstay of colorectal cancer (CRC) and substantially reduces cancer-related morbidity and mortality. Frailty is defined as a biological syndrome, reflecting a state of impaired homeostatic reserve and predisposing to rehospitalisations and deaths in older individuals. Preoperative assessment for frailty is critically important in risk stratification and clinical decision-making. In this systematic review and meta-analysis, we aimed to quantitatively summarise the effect of frailty on postoperative outcomes in geriatric patients receiving surgery for CRC. Methods A systematic literature search was conducted in MEDLINE, Cochrane and EMBASE from inception to 30 April 2020. Fully published articles reporting risk estimate(s) of frailty on postoperative complication(s), readmission and/or mortality in patients aged ≥65 years who received surgery for CRC were eligible for qualitative and quantitative analyses. Results Across 10 articles of 9 unique studies (n = 69332) that were eventually included in the systematic review and meta-analysis, overall prevalence of frailty was 23.0% (95% CI: 11–43%, I2 = 100%). Odds ratios (ORs) on overall and severe postoperative complications were respectively increased by 2.36- (95% CI: 1.66–3.35, P Conclusions In the studies reviewed, frailty appeared to be associated with increased risks for postoperative complications, readmission and mortality during 12 months in patients aged ≥65 years who received surgery for CRC. Nevertheless, no significant association between frailty and 30-day/inpatient mortality was observed.