Research Square · Jul 15, 2022
Impact of Frailty on Treatment Outcomes for Elderly Patients with Gastric Cancer Undergoing Gastrectomy: A Prospective Cohort Study
By Sakurai K, Kubo N, Hasegawa T et al.
Abstract Objective. The aim of this study was to elucidate treatment outcomes for frail patients with gastric cancer (GC) who undergo gastrectomy.Methods. Frailty was assessed preoperatively by frailty index (FI) in 209 patients aged 65 and over undergoing gastrectomy for GC. Patients were assigned into two groups (frail vs. non-frail). Short-term outcomes and loss of independence (LOI) after discharge were compared. Results. Frail patients undergoing gastrectomy had more intraoperative blood transfusions, longer hospital stays, and higher medical costs. The overall complication rate was significantly higher in frail patients. Pneumonia and urinary tract infections were more frequent in the frail patients. In multivariate analysis for LOI after discharge, frailty, older age (≧ 75 years), and open surgery were independent risk factors. A risk score assigning 1 point for each of these variables was useful in predicting postoperative LOI (LOI: score 0, 6.8%; score 1, 26.1%; score 2, 47.6%; score 3, 100%; area under the curve [AUC]=0.748.) Conclusions. Frailty is associated with LOI after gastrectomy in elderly GC patients. A simple risk score assigning points for frailty, age ≧75, and open surgery was an accurate predictor of postoperative LOI. We propose that frailty screening should be applied for all elderly GC patients before surgery.