{"title":"The transition to person-centered care: Putting patient priorities at the heart of decision-making","authors":"Suzanne Festen","doi":"10.1016/j.jgo.2026.102904","DOIUrl":"10.1016/j.jgo.2026.102904","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102904"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Wang , Maya Anand , Kah Poh Loh , AnnaLynn M. Williams , Sally A. Norton , Christopher L. Seplaki
{"title":"Helping caregivers of older adults with cancer manage patient care: A qualitative analysis of healthcare professional perspectives","authors":"Ying Wang , Maya Anand , Kah Poh Loh , AnnaLynn M. Williams , Sally A. Norton , Christopher L. Seplaki","doi":"10.1016/j.jgo.2026.102921","DOIUrl":"10.1016/j.jgo.2026.102921","url":null,"abstract":"<div><h3>Introduction</h3><div>Family and/or unpaid caregivers play an important role in managing care for older adults with cancer (aged ≥65 years). Despite the development of theoretical models that emphasize the need for medical teams to assess caregiver abilities and integrate this assessment into patient care plans, little is known about what specific caregiver abilities should be prioritized for assessment and how such assessments should be conducted.</div></div><div><h3>Materials and methods</h3><div>In this interpretive description qualitative study, we conducted individual, semi-structured interviews with healthcare professionals (HCPs) who are involved in caring for older adults with cancer. All participants were recruited from a single large academic medical center between June and September 2024. The interviews focused on: (1) the caregiver abilities of interest to HCPs, (2) how HCPs assess these abilities, and (3) how HCPs respond to caregiver-reported deficits in these abilities. All interviews were audio-recorded and transcribed. Two analysts analyzed the transcripts using inductive thematic analysis and open coding.</div></div><div><h3>Results</h3><div>We interviewed 19 HCPs from diverse specialties (mean age: 45 ± 1.7 years, 90% female, 90% White). HCPs expressed interest in various caregiver abilities, including physical or functional capacity, cognitive function, medical knowledge and skills, emotional ability to cope with cancer diagnosis, financial ability (e.g., accessing medications), and availability. HCPs reported assessing caregiver abilities based on interactions with caregivers or using informal direct questions. They also reported several challenges in this assessment such as time limitations in clinical settings and ambiguity regarding their responsibility in evaluating caregiver abilities. When responding to deficits in caregivers' abilities, HCPs usually encourage caregivers to seek available social support or connect them with relevant resources. If caregivers need to develop specific caregiving skills, HCPs use more deliberate methods (e.g., a teach-back approach) to evaluate their abilities and provide direct support, including helping simplify caregiving tasks, providing necessary supplies or equipment, and offering various learning methods.</div></div><div><h3>Discussion</h3><div>We did not identify a systematic approach among HCPs to assessing these abilities. Given HCP-reported challenges in this assessment, our study highlights the need for a formal caregiver ability assessment to identify caregiver challenges and inform patient care plan development.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102921"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Curry , Sunita Ghosh , Erica Arenovich , Simon Tanguay , Aly-Khan A. Lalani , Daniel Yick Chin Heng , Bimal Bhindi , Naveen S. Basappa , Jeffrey Graham , Georg A. Bjarnason , Rodney H. Breau , Vincent Castonguay , Denis Soulieres , Frederic Pouliot , Dominick Bosse , Christian K. Kollmannsberger , Antonio Finelli , Nazanin Fallah-Rad , Maryam Soleimani
{"title":"Real-world management and clinical outcomes of first line treatment of advanced renal cell carcinoma in older patients in Canada","authors":"Lauren Curry , Sunita Ghosh , Erica Arenovich , Simon Tanguay , Aly-Khan A. Lalani , Daniel Yick Chin Heng , Bimal Bhindi , Naveen S. Basappa , Jeffrey Graham , Georg A. Bjarnason , Rodney H. Breau , Vincent Castonguay , Denis Soulieres , Frederic Pouliot , Dominick Bosse , Christian K. Kollmannsberger , Antonio Finelli , Nazanin Fallah-Rad , Maryam Soleimani","doi":"10.1016/j.jgo.2026.102905","DOIUrl":"10.1016/j.jgo.2026.102905","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a paucity of data with respect to optimal management of metastatic renal cell carcinoma (mRCC) in older patients. Real-world data may help close this knowledge gap and improve care in this understudied and growing patient population.</div></div><div><h3>Materials and methods</h3><div>The Canadian Kidney Cancer information system (CKCis) was utilized to identify patients with mRCC, categorizing them as either older (defined as age ≥ 75 years) or younger (age < 75 years). Our primary objective was to identify if first line (1 L) mRCC management strategies differed by age. Secondary outcomes of interest were potential differences in treatment-related toxicities, overall survival (OS), progression free survival (PFS), and time to treatment discontinuation (TTD) by age.</div></div><div><h3>Results</h3><div>In total, 2585 patients were included (<75 years of age <em>n</em> = 2205; ≥ 75 years of age <em>n</em> = 380). Baseline demographics were comparable between cohorts, though older patients more often had five or more comorbidities (95% vs. 67%, <em>p</em> < 0.001) and more frequently had Karnofsky Performance Status ≤70% (19% vs. 13%, <em>p</em> = 0.002). Older patients underwent metastasectomy (15% vs. 24%, <em>p</em> < 0.001) and cytoreductive nephrectomy less frequently (2% vs. 7%, <em>p</em> = 0.047), and were less likely to be enrolled in clinical trials (10% vs. 23%, <em>p</em> < 0.001). Older patients received 1 L targeted monotherapy more frequently than immune checkpoint inhibitor (ICI)-based therapy in the post-ICI era (65% vs. 44%, <em>p</em> < 0.001). Older patients did not experience more treatment-related toxicities from ICI-based therapy. Older patients experienced shorter OS when controlling for International mRCC Database Consortium (IMDC) classification, comorbidities, and histology (HR 1.25, 95% CI 1.1–1.4, <em>p</em> = 0.003) in the overall cohort.</div></div><div><h3>Discussion</h3><div>Patients ≥75 years of age received 1 L targeted monotherapy more frequently than those <75 years of age, though when they received combination ICI-based therapy, they did not experience more treatment-related toxicities. Clinicians should individualize treatments for older patients not strictly based on age, but after discussion of available options in a patient-centered manner, considering comorbidities, disease burden, and patient preferences.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102905"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Re: What nutritional interventions can effectively treat sarcopenia in older adults with cancer? A systematic review","authors":"Erkan Topkan , Ugur Selek","doi":"10.1016/j.jgo.2026.102942","DOIUrl":"10.1016/j.jgo.2026.102942","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102942"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147386010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fay J. Strohschein , Hanneke van der Wal-Huisman , K. Alix Hayden , Kristen R. Haase , Michelle Hannan , Cindy Kenis , Juan Li , Nikita Nikita , Sophie Pilleron , Tracy Ruegg , Heike Schmidt , Anke Steckelberg , Cassandra Vonnes , Martine Puts
{"title":"Nursing practice in cancer treatment decision making among older adults: A scoping review on behalf of the International Society of Geriatric Oncology Nursing, Allied Health, and Scientists Interest Group","authors":"Fay J. Strohschein , Hanneke van der Wal-Huisman , K. Alix Hayden , Kristen R. Haase , Michelle Hannan , Cindy Kenis , Juan Li , Nikita Nikita , Sophie Pilleron , Tracy Ruegg , Heike Schmidt , Anke Steckelberg , Cassandra Vonnes , Martine Puts","doi":"10.1016/j.jgo.2026.102906","DOIUrl":"10.1016/j.jgo.2026.102906","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer treatment decision making (CTDM) presents important challenges among older adults due to variation in health and functional status, presence of comorbidities, differing goals/values, quality and quantity of life considerations, and limited inclusion in clinical trials. Nursing standards and guidelines call for competence in supporting CTDM and nurses advocate for greater involvement. However, clear understanding of the existing evidence to inform nursing practice is lacking.</div><div>We aimed to map and synthesize evidence that provides insight into nursing practice in CTDM among older adults, with attention to nursing roles, required skills and competencies, potential barriers and facilitators, and outcomes studied.</div></div><div><h3>Materials and Methods</h3><div>Following JBI (formerly Joanna Briggs Institute) methodology for scoping reviews, we included empirical articles that describe nursing contribution, individually or as part of a multidisciplinary team (MDT), related to CTDM for active (curative or non-curative) treatment among adults aged ≥60 years diagnosed with cancer. Nine databases were searched systematically from inception to January 2024, no limits applied. Two independent reviewers screened identified records and full texts, then systematically extracted data from included articles. Basic qualitative content analysis was conducted on charted data.</div></div><div><h3>Results</h3><div>Of the 9582 records screened, 980 full texts were assessed for eligibility; 84 reports describing 78 studies were included. Conducted primarily in the United States or United Kingdom, studies described nursing interventions, nursing involvement in geriatric assessment and MDT meetings/clinics, and the perspectives of patients, family, and/or healthcare professionals. Although seldom the primary focus, researchers have highlighted the important roles of nurses in the CTDM process, before, during, and after consultations with physicians and MDT meetings, which require disease-specific knowledge and relational skills. MDT collaboration, training, dedicated time and space, adequate resources, and support from leadership are critical to promoting involvement, with potential impact on decision satisfaction and optimal treatment decisions. The value of nurses' involvement is endorsed by patients, family, and other healthcare professionals.</div></div><div><h3>Discussion</h3><div>Nurses play a vital role in CTDM among older adults, particularly in the MDT context. However, rigorous studies demonstrating the impact of nursing practice on CTDM outcomes among older adults are lacking. Further research is needed to inform nursing practice and interventions.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102906"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kofi Gyasi Agyei , Arul Malhotra , Sally A. Norton , Mostafa Mohamed , Katherine M. Juba , Supriya Mohile , Erika Ramsdale
{"title":"Barriers and facilitators of deprescribing for older adults with cancer and polypharmacy","authors":"Kofi Gyasi Agyei , Arul Malhotra , Sally A. Norton , Mostafa Mohamed , Katherine M. Juba , Supriya Mohile , Erika Ramsdale","doi":"10.1016/j.jgo.2026.102933","DOIUrl":"10.1016/j.jgo.2026.102933","url":null,"abstract":"<div><h3>Introduction</h3><div>Polypharmacy affects up to 93% of older adults with cancer and increases risks of treatment toxicity, drug interactions, and adverse outcomes. Deprescribing, the planned discontinuation of potentially inappropriate medications, can mitigate these risks. However, deprescribing interventions in oncology clinics remain understudied outside palliative care settings. This study aimed to identify barriers and facilitators to deprescribing in the oncology clinic across multiple stakeholder groups.</div></div><div><h3>Materials and methods</h3><div>Between November 2020 and August 2021, virtual focus groups were conducted with five key informant groups: patients (<em>n</em> = 9), primary care physicians (<em>n</em> = 7), oncology pharmacists (n = 7), oncology nurses (n = 7), and oncologists (<em>n</em> = 6). Participants were recruited from the University of Rochester Wilmot Cancer Institute, affiliated sites, and a patient advisory board. Semi-structured interview guides explored topics including polypharmacy definitions, medication communication, workflows, and deprescribing strategies. Sessions were audio-recorded, transcribed verbatim, and analyzed using inductive content analysis with MAXQDA software. Two coders performed open coding and developed themes categorized at patient, healthcare provider, and system levels.</div></div><div><h3>Results</h3><div>At the patient level, barriers included resistance to change, lack of awareness, mistrust, and health complexity, while facilitators included education/empowerment, effective communication, and caregiver involvement. At the provider level, barriers encompassed knowledge gaps, scope of practice concerns, and time limitations, with facilitators including inter-provider communication, education, longitudinal approaches, and provider maturity. System-level barriers included care fragmentation, electronic health record limitations, and automated workflows, while facilitators emphasized team-based care, decision support tools, and pharmacist integration. Notably, all groups expressed consistent enthusiasm for pharmacist involvement in deprescribing interventions.</div></div><div><h3>Discussion</h3><div>This analysis revealed multilevel barriers and facilitators to deprescribing in older adults with cancer. Mismatches between provider perceptions and patient attitudes suggest opportunities for improved communication. Time constraints and scope of practice concerns were prominent provider barriers, addressable through longitudinal approaches and team-based models. The consistent enthusiasm across all stakeholder groups for pharmacist-led interventions informed the design of a subsequent cluster-randomized trial. These findings suggest scalable interventions leveraging pharmacist expertise and decision support tools to address polypharmacy in this vulnerable population.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102933"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonina Obayo , Francine Antoinette Ocampo , Baldwin Lau , Samantha Bowyer , Christopher Etherton-Beer , Rosemary Saunders , Heather Lane
{"title":"Geriatric assessment practices in oncology: A survey of Australian clinicians","authors":"Antonina Obayo , Francine Antoinette Ocampo , Baldwin Lau , Samantha Bowyer , Christopher Etherton-Beer , Rosemary Saunders , Heather Lane","doi":"10.1016/j.jgo.2026.102927","DOIUrl":"10.1016/j.jgo.2026.102927","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102927"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Geriatric assessment is the future: Retiring Karnofsky and ECOG performance status in modern cancer care","authors":"Stuart M. Lichtman","doi":"10.1016/j.jgo.2026.102934","DOIUrl":"10.1016/j.jgo.2026.102934","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102934"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick M. Reagan , Allison Magnuson , Craig A. Portell , Andrea Baran , Carla Casulo , Alyssa R. Williams , Danielle S. Wallace , Paul M. Barr , Jonathan W. Friedberg
{"title":"Brentuximab vedotin and dose attenuated chemoimmunotherapy for patients 75 years and older with diffuse large B-cell lymphoma with analysis of outcomes by frailty","authors":"Patrick M. Reagan , Allison Magnuson , Craig A. Portell , Andrea Baran , Carla Casulo , Alyssa R. Williams , Danielle S. Wallace , Paul M. Barr , Jonathan W. Friedberg","doi":"10.1016/j.jgo.2026.102932","DOIUrl":"10.1016/j.jgo.2026.102932","url":null,"abstract":"<div><h3>Introduction</h3><div>Dose attenuated rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-miniCHOP) is a curative-intent regimen that balances safety and efficacy in older patients with diffuse large B-cell lymphoma (DLBCL). Incorporation of targeted agents into this backbone and the use of geriatric assessments (GA) are research priorities. Brentuximab vedotin (BV) is an anti-CD30 antibody drug conjugate that is active in DLBCL and has been safely combined with chemoimmunotherapy in younger patients. We conducted a feasibility study of BV in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (R-miniCHP), integrating GA and frailty assessment to describe the physiologic health of the cohort.</div></div><div><h3>Materials and methods</h3><div>Patients aged 75 years and older with DLBCL were treated with six cycles of BV and R-miniCHP. All patients underwent GA at screening, following prephase and at the end of treatment. Frailty was determined using the Deficit Accumulation Frailty Index (DAFI) using clinical and GA variables. The primary feasibility endpoint was the treatment completion rate. Secondary endpoints included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and complete response (CR). Exploratory endpoints included PFS, OS, ORR, and CR by CD30 status, and PFS and OS by DAFI score.</div></div><div><h3>Results</h3><div>We enrolled 22 patients with a median age of 77.5 years (range 75–91). Seventeen patients (77.3%) completed six cycles of BV-R-miniCHP. The ORR was 85.7% (71.4% CR). With a median follow up of 4.3 years, the median PFS was not reached and the two-year PFS was 63.6% (90% CI = 44.3%, 77.8%). There was no difference in response, or survival by CD30 status.</div><div>All 22 patients completed components of the baseline GA. There was no difference in two-year PFS (non-frail 50.0% (90% CI =23.0%, 72.1%) vs prefrail/frail 75.0% (90% CI = 47.4%, 89.5%), <em>p</em> = 0.49) or OS (non-frail 50.0% (90% CI = 23.0%, 72.1%) vs prefrail/frail 83.3% (90% CI =55.7%, 94.5%), <em>p</em> = 0.22) based on frailty as measured by DAFI score.</div><div>Hematologic toxicities and infections were the most common grade ≥ 3 adverse events. Ten patients (45%) reported a total of 16 serious adverse events. There were two deaths during treatment.</div></div><div><h3>Discussion</h3><div>Incorporation of GA and BV R-miniCHP is feasible in untreated, older adults with DLBCL.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102932"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of frailty on early postoperative outcomes of lobectomy for lung cancer in older adults – A United States National Retrospective Cohort Study","authors":"Diana Barragan-Bradford , Ruben Oganesyan , Alexander Nagrebetsky , Omar Hyder","doi":"10.1016/j.jgo.2026.102920","DOIUrl":"10.1016/j.jgo.2026.102920","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulmonary lobectomy represents the primary curative treatment for lung cancer in older adults, yet frailty's impact on critical early postoperative outcomes remains inadequately characterized. This analysis examined the effect of preoperative frailty on early postoperative mortality and failure-to-rescue in a contemporary national cohort.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study analyzed older adults undergoing pulmonary lobectomy for lung cancer using the National Inpatient Sample (2016–2022). The Johns Hopkins Adjusted Clinical Groups (ACG) frailty indicator and Hospital Frailty Risk Score (HFRS) were used to identify frail patients. Multivariable logistic regression examined associations between frailty and failure-to-rescue (death after postoperative complications) and 14-day in-hospital mortality.</div></div><div><h3>Results</h3><div>Among 110,460 patients aged ≥65 years, frailty prevalence was 5.7% (<em>n</em> = 6290) by ACG indicator and 19.8% (<em>n</em> = 21,915) by HFRS (≥5). Among ACG-defined frail patients, the most common frailty-defining conditions were dementia (37.8% of frail patients), malnutrition (36.0%), and weight loss (11.6%). Overall complication rate was 39.3%, but frail patients (HFRS ≥5) experienced higher rates (69.0% versus 32.0%), higher hospitalization costs (median $104,446 versus $88,532), and reduced likelihood of home discharge (83.3% versus 95.5%; all <em>p</em> < 0.001). Overall 14-day mortality was 0.8%. Frail patients had higher rates of failure-to-rescue (ACG: 3.7% versus 1.7%; HFRS: 4.1% versus 0.8%) and mortality (ACG: 2.1% versus 0.7%; HFRS: 2.8% versus 0.3%; all <em>p</em> < 0.001) compared with non-frail patients. After multivariable adjustment, frailty remained associated with failure-to-rescue (ACG: OR 2.01, 95% CI 1.36–3.06; HFRS: OR 4.66, 95% CI 3.27–6.63) and 14-day mortality (ACG: OR 2.70, 95% CI 1.77–4.10; HFRS: OR 9.30, 95% CI 6.52–13.26). Frailty accounted for 68% of early deaths within the frail cohort and 11% of all cohort deaths.</div></div><div><h3>Discussion</h3><div>Preoperative frailty was associated with early postoperative mortality and failure-to-rescue rates following pulmonary lobectomy in older adults, emphasizing the need for systematic frailty assessment, enhanced perioperative surveillance, and targeted interventions for this population.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 3","pages":"Article 102920"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}