![]() In older oncological patients, the TUG seems to be an interesting indicator of the ability to withstand stressors such as chemotherapy or oncologic surgery. This is a time-saving, inexpensive and easy to administer screening tool for physical performance, integrating information on multiple domains, such as gait speed, balance and strength. One of the tests used to objectify physical performance is the Timed Up & Go test. Functional tests can integrate known and unrecognized disturbances in multiple organ systems, such as heart, lungs, circulatory and musculoskeletal systems. Physical performance and functioning appear to be a proxy for the health status in older adults. However, data on functional capacity in older adults undergoing oncologic surgery are scarce.īefore studying the effects of exercise as part of prehabilitation on long term survival in older adults going for oncologic surgery, it is essential to be informed on baseline physical functioning and long-term survival in these patients. Previous studies suggest that preoperative exercise may have beneficial effects on length of hospital stay, functional recovery and postoperative complications. Prehabilitation consists mainly of endurance and resistance exercises. ![]() To improve postoperative outcomes in this group of patients, multiple interventions have been developed: prehabilitation is intended to enhance the functional capacity prior to surgery, enabling to withstand stressful events like surgery. ![]() Predicting which patient is at risk for postoperative adverse outcomes remains difficult and thus the management of older adults with solid cancer is challenging. Whilst older adults considered fit for surgery might do as well as younger patients, vulnerable or frail patients are at an increased risk of adverse postoperative outcomes. However, the ability to withstand major stressors like surgery varies greatly in the geriatric population undergoing oncologic surgery. For many of these solid types of cancer, surgery remains the most efficient treatment. Cancer is a disease of ageing, and solid types of cancer predominantly affect the aged. The global burden of cancer is rapidly increasing, the number of new cancer cases among older adults is expected to double by 2035 compared to 2012. The PREOP study was registered with the Dutch trial registry at NL1497 () and in the United Kingdom register (Research Ethics Committee reference 10/H1008/59). The PICNIC studies are registered in the Dutch Clinical Trial database at NL4219 () and NL4441 (). It requires further investigation whether an impaired TUG can be reversed and thus improve long-term outcomes. ![]() ConclusionsĪn impaired TUG is associated with increased 5-year mortality in older adults undergoing surgery for solid tumors. The TUG was not a significant predictor of 30-day major complications (aOR 1.46, 95% CI 0.70-3.06). An impaired TUG was an independent predictor of increased 5-year mortality (aHR 1.43, 95% CI 1.02-2.02). Five-year survival proportions were 0.56 and 0.49 for patients with normal TUG and impaired TUG respectively. Mean age was 75 years (SD 5.98), in 123 (23.3%) patients, the TUG was impaired. In total, 528 patients were included into analysis. Hazard ratios (aHRs) and Odds ratios (aOR) were adjusted for literature-based and clinically relevant variables, and 95% confidence intervals (95% CIs) were estimated using multivariable models. Cox- and logistic regression analysis were used for survival and complications respectively. Survival proportions were estimated using Kaplan-Meier curves. Primary endpoint was 5-year survival, secondary endpoint was 30-day major complications. The TUG was administered 2 weeks before surgery, a score of ≥12 seconds was considered to be impaired. Patients aged ≥65 years undergoing surgery for solid tumors in three prospective cohort studies, ‘PICNIC’, ‘PICNIC B-HAPPY’ and ‘PREOP’, were included. The objective of this study is to investigate the association between physical performance and long term outcomes. In older adults undergoing oncologic surgery, an impaired TUG has been associated with higher rates of postoperative complications and increased short term mortality. The Timed Up and Go test is an easy-to-administer tool measuring physical performance. Physical performance tests are a reflection of health in older adults.
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