The Frailty Based on the Memorial Sloan Kettering Frailty Index for Prediction of Surgical Outcome in Advance Epithelial Ovarian Cancer-Experience of a Single Center in Mexico.
Jorge Luis Aguilar-FrascoFrancisco Armillas-CansecoFernanda Rivera-SánchezPaulina Moctezuma-VelazquezCarlos Moctezuma-VelazquezEmma CastroFrancisco U Pastor-SifuentesCristian Axel Hernández-GaytánAlejandro Alfaro-GoldaracenaHeriberto Medina-FrancoPublished in: Indian journal of surgical oncology (2022)
Retrospective impact evaluation of frailty as measured by the Memorial Sloan Kettering Frailty Index (MSK-FI) on outcomes in older women surgically treated for advanced epithelial ovarian cancer (EOC). Women ≥ 60 years with stage IIIC/IV EOC who underwent primary debulking surgery (PDS) or interval debulking surgery (IDS) were included. Medical records were reviewed for patients' characteristics and outcomes. We retrospectively applied the MSK-FI which included 10 comorbidities and functional assessment that were extracted from medical records. The MSK-FI ranges from 0 to 11; a score of ≥ 3 was considered frail. Associations were assessed using logistic regression and Cox proportional hazards regression. We identified 79 patients treated with PDS ( n = 36, 45.5%) or IDS ( n = 43, 54.4%) with complete data. The prevalence of frailty based on MSK-FI was 25%. Almost half of the frail patients (47.3%) were admitted to the ICU compared to 16% of non-frail patients ( p = 0.006). In univariable analysis, the MSK-FI was associated with postoperative complications [OR 1.57 (95% CI 1.04-2.37), p = 0.03] and ICU admission [OR 2.05 (95% CI 1.30-3.23), p = 0.002], but not with readmission rate [OR 1.29 (95% CI 0.65-2.59), p = 0.5], postoperative mortality [OR 1.02 (95% CI 0.51-2.00), p = 0.9], and hospital stay [β 0.60 (95% CI - 1.19-2.41)]. In multivariable analysis, the frailty index was independently associated with postoperative complications [OR 1.54 (95% CI 1.02-2.34), p = 0.04] and ICU admissions [OR 1.97 (95% CI 1.23-3.16), p = 0.004]. Frailty, based on the Memorial Sloan Kettering Frailty Index, is associated with adverse postoperative outcomes in older women with advanced ovarian cancer, suggesting that MSK-FI can improve the predictive ability of current surgical assessment tools.
Keyphrases
- community dwelling
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- intensive care unit
- prognostic factors
- emergency department
- peritoneal dialysis
- physical activity
- squamous cell carcinoma
- neoadjuvant chemotherapy
- radiation therapy
- metabolic syndrome
- machine learning
- polycystic ovary syndrome
- electronic health record
- coronary artery bypass
- percutaneous coronary intervention