Frailty assessment tools predict perioperative outcome in elderly patients with endometrial cancer better than age or BMI alone: a retrospective observational cohort study

Publication type:
Journal article
Metadata:
Abstract
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Objective</jats:title> <jats:p>Five commonly used global health assessment tools have been evaluated to identify and assess the preoperative frailty status and its relationship with perioperative in-hospital complications and transfusion rates in older women with endometrial cancer (EC).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Preoperative frailty status was examined by the G8 questionnaire, the Eastern Cooperative Oncology Group performance status, the Charlson Comorbidity Index and the American Society of Anesthesiologists Physical Status System, as well as the Lee-Schonberg prognostic index. The main outcome measures were perioperative laboratory values, intraoperative surgical parameters and immediately postoperative complications.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>153 consecutive women ≥ 60 years with all stages of EC, who received primary elective surgery at the University Medical Center Mainz between 2008 and 2019 were classified with selected global health assessment tools according to their preoperative performance status. In contrast to conventional prognostic parameters like older age and higher BMI, increasing frailty was significantly associated with preoperative anemia and perioperative transfusions (<jats:italic>p</jats:italic> &lt; 0.05). Moreover, in patients preoperatively classified as frail significantly more postoperative complications (G8 Score: frail: 20.7% vs. non-frail: 6.7%, <jats:italic>p</jats:italic> = 0.028; ECOG: frail: 40.9% vs. non-frail: 2.8%, <jats:italic>p</jats:italic> = 0.002; and CCI: frail: 25.0% vs. non-frail: 7.4%, <jats:italic>p</jats:italic> = 0.003) and an increased length of hospitalization were recorded. According to propensity score matching, the risk for developing postoperative complications for frail patients was approximately two-fold higher, depending on which global health assessment tool was used.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Preoperatively assessed frailty significantly predicts post-surgical morbidity rates in contrast to conventionally used single prognostic parameters such as age or BMI. A standardized preoperative assessment of frailty in the routine work-up might be beneficial in older cancer patients before major surgery to include these patients in a prehabilitation program with nutrition counseling and physiotherapy to adequately assess the perioperative risk.</jats:p> </jats:sec>
Autoren
  • Katharina Anic
  • Friedrich Flohr
  • Mona Wanda Schmidt
  • Slavomir Krajnak
  • Roxana Schwab
  • Marcus Schmidt
  • Christiane Westphalen
  • Clemens Eichelsbacher
  • Christian Ruckes
  • Walburgis Brenner
  • Annette Hasenburg
  • Marco Johannes Battista
DOI
10.1007/s00432-022-04038-6
eISSN
1432-1335
ISSN
0171-5216
Ausgabe der Veröffentlichung
4
Zeitschrift
Journal of Cancer Research and Clinical Oncology
Sprache
en
Online publication date
2022
Paginierung
1551 - 1560
Datum der Veröffentlichung
2023
Status
Published
Herausgeber
Springer Science and Business Media LLC
Herausgeber URL
http://dx.doi.org/10.1007/s00432-022-04038-6
Datum der Datenerfassung
2023
Titel
Frailty assessment tools predict perioperative outcome in elderly patients with endometrial cancer better than age or BMI alone: a retrospective observational cohort study
Ausgabe der Zeitschrift
149

Data source: Crossref

Other metadata sources:
Author's licence
CC-BY
Autoren
  • Katharina Anic
  • Friedrich Flohr
  • Mona Wanda Schmidt
  • Slavomir Krajnak
  • Roxana Schwab
  • Marcus Schmidt
  • Christiane Westphalen
  • Clemens Eichelsbacher
  • Christian Ruckes
  • Walburgis Brenner
  • Annette Hasenburg
  • Marco Johannes Battista
Hosting institution
Universitätsbibliothek Mainz
Sammlungen
  • DFG-491381577-H
Resource version
Published version
DOI
10.1007/s00432-022-04038-6
Funding acknowledgements
  • Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - Projektnummer 491381577
File(s) embargoed
false
Open access
true
ISSN
1432-1335
Zeitschrift
Journal of cancer research and clinical oncology
Schlüsselwörter
  • 610 Medizin
  • 610 Medical sciences
Sprache
eng
Open access status
Open Access
Datum der Veröffentlichung
2022
Public URL
https://openscience.ub.uni-mainz.de/handle/20.500.12030/8354
Herausgeber
Springer
Datum der Datenerfassung
2023
Datum, an dem der Datensatz öffentlich gemacht wurde
2023
Zugang
Public
Titel
Frailty assessment tools predict perioperative outcome in elderly patients with endometrial cancer better than age or BMI alone : a retrospective observational cohort study
Ausgabe der Zeitschrift
Version of Record (VoR)

Files

frailty_assessment_tools_pred-20221117160146575.pdf

Data source: OPENSCIENCE.UB

Tools