Surgical care for older adults is undergoing a paradigm shift from a procedure-centered to a patient-centered model that prioritizes functional recovery, autonomy, and quality of life. Frailty has emerged as a more powerful predictor of outcomes than chronological age, reshaping perioperative decision-making and risk assessment. At the same time, interdisciplinary care has evolved from traditional consultation-based approaches to integrated co-management models shared by surgeons and geriatricians. Consequently, surgical success is increasingly defined not only by survival and complication rates, but also by the patient's ability to maintain independence and return to meaningful function. In light of these developments, the authors advocate for the recognition of geriatric surgery as a distinct surgical discipline.

Kashtan, Hanoch MD*,†; Cooper, Lisa MD‡,§; Festen, Suzanne MD, PhD∥; van Leeuwen, Barbara L. MD, PhD¶; Tan, Kok-Yang MBBS, MMed (Surg)#,**; Montroni, Isacco MD, PhD††; Somasundar, Ponnandai MD‡‡; Steimer, Desiree A. MD§§; Pommerening, Matthew MD§§; Orgad, Ran MD, PhD*,†; Saur, Nicole M. MD∥∥; Audisio, Riccardo A. MD, PhD¶¶; Jaklitsch, Michael T. MD§§; On behalf of the International Society of Geriatric Oncology (SIOG) Surgical & Perioperative Optimization Collaborative. Rethinking Perioperative Care in Older Adults: A Plea for Specialization. Annals of Surgery Open 7(2):p e684, June 2026. | DOI: 10.1097/AS9.0000000000000684