Use of the Rockwood Clinical Frailty Scale in patients with advanced hepatopancreaticobiliary malignancies.
Expert Rev Anticancer Ther
; 22(9): 1009-1015, 2022 09.
Article
em En
| MEDLINE
| ID: mdl-35768183
ABSTRACT
BACKGROUND:
Co-existing frailty in older patients with hepatopancreaticobiliary (HPB) malignancies is common. This study assessed the relationship between the Rockwood Clinical Frailty scale (CFS) and systemic anti-cancer therapy dose intensity (SACT-DI) and overall survival (OS) in patients with advanced HPB malignancies. RESEARCH DESIGN ANDMETHODS:
CFS was assessed prospectively for consecutive patients with newly diagnosed advanced HPB malignancy (The Christie; Sep-2019 to June-2020). Mann-Whitney U test assessed association between CFS, ECOG Performance Status (ECOG PS), and SACT-DI and Spearman's rank assessed the association between ECOG PS, age, and frailty. Survival analysis was performed using Kaplan-Meier and Cox regression.RESULTS:
Two hundred patients met inclusion criteria. SACT-DI was higher in Group-1 (not frail) (CFS 1-3)(median = 61%) than Group-2 (vulnerable/mildly frail) (CFS 4-5)(median = 25.1%), p < 0.001. Median OS was shorter in frail and pre-frail patients (HR 2.3(95%CI 1.8-2.9),p < 0.001. On multivariable analysis, both CFS (HR 1.5-(95%CI 1.2-1.9), p = 0.002) and ECOG PS (HR 1.9 (95%CI 1.6-2.3), p < 0.001) were independent prognostic factors for OS.CONCLUSION:
Frailty assessments, in addition to ECOG PS, may identify patients that will benefit from systemic therapy and are both independent prognostic factors for OS.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Fragilidade
/
Neoplasias
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Aged
/
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article