Original article Multidisciplinary Management and Optimization of Frail or High Surgical Risk Patients in Colorectal Cancer Surgery: Prospective Observational Analysis § Sheila Serra-Pla, a, * Anna Pallisera-Lloveras, a Laura Mora-Lo ´ pez, a Ana Granados Maturano, b Sebastian Gallardo, c Carmen del Pino Zurita, a,b,c Xavier Serra-Aracil a a Unidad de Cirugı ´a Coloproctolo ´ gica, Hospital Universitari Parc Taulı ´, Sabadell, Barcelona, Spain b Servicio de Medicina Interna, Hospital Universitari Parc Taulı ´, Sabadell, Barcelona, Spain c Servicio de Medicina Paliativa, Hospital Universitari Parc Taulı ´, Sabadell, Barcelona, Spain c i r e s p . 2 0 2 0 ; 9 8 ( 7 ) : 3 8 9 – 3 9 4 article info Article history: Received 20 September 2019 Accepted 14 January 2020 Available online 2 August 2020 Keywords: Frailty Geriatrics Surgery in the elderly Colorectal cancer a b s t r a c t Introduction: Frailty is associated with greater postoperative morbidity and mortality. Indi- vidualized multidisciplinary management of these patients can improve the quality of care. The objectives of this study are to determine the percentage of frail patients with colorectal cancer in our population, and to describe the morbidity and mortality associated with surgery and the evolution of palliative treatment. Methods: A prospective, observational study of patients with surgical colorectal cancer (February 1, 2018–April 30, 2019). Frail patients were screened and classified according to degrees of frailty. Therapeutic decision-making (surgery or palliative treatment) was deter- mined by the degree of fragility and explicit will of the patient. Postoperative comorbidities were analyzed (according to Clavien–Dindo and Comprehensive Complication Index), as were mortality and oncological follow-up. Results: The study included 193 patients with surgical colorectal cancer, with a mean age of 74 years (44–92). Screening identified 46 frail patients (24%), with a mean age of 80 years (57– 92). Twenty-two patients were optimized and underwent surgery (48%), with a mean age of 78 years (57–89). Relevant adverse effect rate was 27.7% (4 grade IVa adverse effects, one IVb and one V, according to Clavien–Dindo). Comprehensive Complication Index was 17.5. Palliative treatment was administered in 24 patients (52%), with a mean age of 82 years (59–92). Mean follow-up was 7.8 months. There were 2 deaths due to disease progression (8.3%), 5 re-consultations due to complications of colorectal cancer (20.1%). § Please cite this article as: Serra-Pla S, Pallisera-Lloveras A, Mora-Lo ´ pez L, Granados Maturano A, Gallardo S, del Pino Zurita C, et al. Manejo multidisciplinar y optimizacio ´n del paciente oncofra ´ gil o de elevado riesgo quiru ´ rgico en cirugı´a del ca ´ ncer colorrectal. Ana ´ lisis observacional prospectivo. Cir Esp. 2020;98:389–394. * Corresponding author. E-mail address: sheilaserrapla@gmail.com (S. Serra-Pla). CIRUGI ´ A ESPAN ˜ OLA www.elsevier.es/cirugia 2173-5077/ # 2020 AEC. Published by Elsevier Espan ˜ a, S.L.U. All rights reserved.