Geriatric Surgical Oncology: Integrating Frailty, Function, and Multidisciplinary Decision-Making in the Care of Older Adults with Cancer

The global rise in life expectancy is rapidly transforming the oncologic surgical population. Older adults now represent the majority of patients diagnosed with solid tumors, yet they remain underrepresented in clinical trials and are often excluded from standardized treatment pathways. Chronological age alone is a poor predictor of surgical risk and oncologic outcomes; frailty, comorbidity burden, cognitive status, nutritional reserve, and functional capacity play a far more decisive role. As a result, surgical decision-making in older patients with cancer requires a tailored, multidimensional approach that goes well beyond traditional preoperative assessment. Comprehensive geriatric assessment (CGA), prehabilitation, and shared decision-making are increasingly recognized as essential components of safe and meaningful cancer surgery in this growing and heterogeneous population.This Research Topic aims to advance the field of geriatric surgical oncology by exploring how the integration of geriatric principles into surgical care can improve patient selection, perioperative management, and long-term outcomes for older adults with cancer. Despite growing evidence supporting CGA-guided pathways, prehabilitation programs, and patient-centered endpoints such as functional recovery and quality of life, implementation across surgical oncology practices remains uneven. Recent advances — including frailty indices, novel risk-prediction tools, enhanced recovery protocols, and international initiatives such as the GOSAFE study — provide a framework to bridge this gap. By bringing together surgeons, geriatricians, medical and radiation oncologists, anesthesiologists, and allied health professionals, this collection seeks to consolidate current evidence, highlight unresolved controversies, and define future directions for personalized, age-attuned surgical oncology care.This Research Topic welcomes contributions that explore clinical, translational, and organizational aspects of surgical oncology in older adults across all tumor types and surgical specialties.We welcome Original Research, Review, Mini Review and Perspective articles on themes including, but not limited to:• Comprehensive geriatric assessment (CGA) and frailty screening in surgical oncology• Prehabilitation, nutritional optimization, and enhanced recovery in older patients• Patient selection and shared decision-making for cancer surgery in advanced age• Perioperative outcomes, functional recovery, and quality of life after oncologic surgery• Management of comorbidities, polypharmacy, and postoperative cognitive dysfunction• Multidisciplinary models of care and dedicated geriatric surgical oncology clinics• Outcomes in nonagenarians and other vulnerable subgroups• Novel endpoints, predictive tools, and biomarkers of surgical resilience in older adultsPlease note: manuscripts consisting solely of bioinformatics or computational analysis of sole public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic. Topic editors: Hanoch Kashtan, Lisa Cooper, Francesco Giovinazzo Source: https://www.frontiersin.org/research-topics/80680/geriatric-surgical-oncology-integrating-frailty-function-and-multidisciplinary-decision-making-in-the-care-of-older-adults-with-cancer