The effect of 5-item modified frailty index on clinical outcomes in elderly rectal cancer patients after curative surgery

Author:

Wu Hong1,Shi Feiyu1,Hu Chenhao1,Zhang Lei1,Qu Penghong1,She Junjun1

Affiliation:

1. The First Affiliated Hospital of Xi’an Jiaotong University

Abstract

Abstract

Frailty is a significant factor contributing to an increased risk of adverse clinical outcomes in older cancer patients. This study aims to investigate the impact of the 5-item modified frailty index (mFI) on both short-term and long-term prognosis in elderly rectal cancer patients who underwent radical resection. And, by integrating the 5-item mFI with clinicopathological characteristics, a postoperative major complications nomogram and a cancer-specific survival (CSS) prediction nomogram were further constructed. Demographic, clinical, and therapeutic data were collected from 1,034 patients aged ≥ 70 years with rectal cancer who underwent proctectomy between 2017 and 2022. Patients were categorized into three groups based on their mFI scores: 318 patients with mFI = 0, 404 patients with mFI = 1, and 312 patients with mFI ≥ 2. Comparisons among these groups revealed that higher 5-item mFI scores were associated with an increased incidence of both overall and major postoperative morbidity, prolonged recovery times, and elevated total medical costs. Multivariate logistic regression analysis indicated that an mFI score of ≥ 2 [odds ratio = 3.145, 95% confidence interval (CI): 2.047–4.833, P < 0.001] was an independent risk factor for major postoperative complications. Similarly, in competing risk analysis, the 5-item mFI was identified as an independent prognostic factor for CSS (subdistribution hazard ratio = 2.00, 95% CI: 1.47–2.72, P < 0.001). The postoperative major complications nomogram and CSS prediction nomogram AUC values were 0.730 and 0.844, respectively, both demonstrating superior predictive capabilities. In conclusion, the 5-item mFI serves as a concise and effective tool for preoperative risk stratification and for predicting clinical outcomes in elderly rectal cancer patients.

Publisher

Springer Science and Business Media LLC

Reference40 articles.

1. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries;Sung H;CA Cancer J Clin,2021

2. Frailty: A Multidimensional Biopsychosocial Syndrome;Cohen CI;Med Clin North Am,2023

3. Management of frailty: opportunities, challenges, and future directions;Dent E;Lance.,2019

4. Frailty: implications for clinical practice and public health;Hoogendijk EO;Lancet,2019

5. Impact of frailty on outcomes in surgical patients: A systematic review and meta-analysis;Am J Surg,2018

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3