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Review
. 2022 Oct 16;14(20):5061.
doi: 10.3390/cancers14205061.

Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review

Yuta Yamada  1 , Satoru Taguchi  1 , Haruki Kume  1
Affiliations
Review

Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review

Yuta Yamada et al. Cancers (Basel). .

Abstract

Robot-assisted radical prostatectomy (RARP) has now become the gold standard treatment for localized prostate cancer. There are multiple elements in decision making for the treatment of prostate cancer. One of the important elements is life expectancy, which the current guidelines recommend as an indicator for choosing treatment options. However, determination of life expectancy can be complicated and difficult in some cases. In addition, surgical tolerability is also an important issue. Since frailty may be a major concern, it may be logical to use geriatric assessment tools to discriminate 'surgically fit' patients from unfit patients. Landmark studies show two valid models such as the phenotype model and the cumulative deficit model that allow for the diagnosis of frailty. Many studies have also developed geriatric screening tools such as VES-13 and G8. These tools may have the potential to directly sort out unfit patients for surgery preoperatively.

Keywords: elderly; frail; frailty; prostate cancer; robot-assisted radical prostatectomy (RARP); surgical tolerability.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowcharts showing recommended use of geriatric tools in decision-making of treatment for prostate cancer. (A) Use of geriatric screening tools and comprehensive geriatric assessment in status quo. (B) Future perspective of direct use of geriatric screening tool to determine surgical tolerability.
See this image and copyright information in PMC

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