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Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer

AIM: With population aging, the number of frail patients with colorectal cancer has increased. The Clinical Frailty Scale (CFS) is a validated tool for assessing frailty, and higher scores indicate worse clinical outcomes following cardiovascular procedures. This retrospective study aimed to examine...

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Autores principales: Mima, Kosuke, Miyanari, Nobutomo, Morito, Atsushi, Yumoto, Shinsei, Matsumoto, Takashi, Kosumi, Keisuke, Inoue, Mitsuhiro, Mizumoto, Takao, Kubota, Tatsuo, Baba, Hideo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382441/
https://www.ncbi.nlm.nih.gov/pubmed/32724884
http://dx.doi.org/10.1002/ags3.12337
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author Mima, Kosuke
Miyanari, Nobutomo
Morito, Atsushi
Yumoto, Shinsei
Matsumoto, Takashi
Kosumi, Keisuke
Inoue, Mitsuhiro
Mizumoto, Takao
Kubota, Tatsuo
Baba, Hideo
author_facet Mima, Kosuke
Miyanari, Nobutomo
Morito, Atsushi
Yumoto, Shinsei
Matsumoto, Takashi
Kosumi, Keisuke
Inoue, Mitsuhiro
Mizumoto, Takao
Kubota, Tatsuo
Baba, Hideo
author_sort Mima, Kosuke
collection PubMed
description AIM: With population aging, the number of frail patients with colorectal cancer has increased. The Clinical Frailty Scale (CFS) is a validated tool for assessing frailty, and higher scores indicate worse clinical outcomes following cardiovascular procedures. This retrospective study aimed to examine preoperative frailty in relation to recurrence and mortality following curative resection of colorectal cancer. METHODS: We retrospectively analyzed data for 729 consecutive patients undergoing curative resection of stage I–stage III colon and rectal adenocarcinoma between January 2009 and December 2016. Frailty was assessed using the CFS: 1 (very fit) to 9 (terminally ill), and frailty was defined as CFS ≥ 4. Recurrence‐free survival (RFS) and overall survival (OS) were compared between frail and nonfrail patients. Cox proportional hazards model was used to calculate hazard ratios (HRs), controlling for potential confounders. RESULTS: CFS score was negatively correlated with the Barthel index of activities of daily living (Spearman's ρ = −0.83). Of the 729 patients, 253 (35%) were frail. In multivariable analyses adjusting for potential confounders including age and disease stage, frailty was independently associated with shorter RFS (multivariable HR: 1.70, 95% confidence interval: 1.25‐2.31, P < .001) and OS (multivariable HR: 2.04, 95% confidence interval: 1.40‐2.99, P < .001). There were no significant interactions of frailty with age and disease stage regarding RFS and OS (P (interaction) > .72). CONCLUSION: Preoperative frailty was independently associated with shorter RFS and OS following resection of nonmetastatic colorectal cancer, regardless of age and disease stage. Further trials are needed to establish treatment strategies for frail patients with colorectal cancer.
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spelling pubmed-73824412020-07-27 Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer Mima, Kosuke Miyanari, Nobutomo Morito, Atsushi Yumoto, Shinsei Matsumoto, Takashi Kosumi, Keisuke Inoue, Mitsuhiro Mizumoto, Takao Kubota, Tatsuo Baba, Hideo Ann Gastroenterol Surg Original Articles AIM: With population aging, the number of frail patients with colorectal cancer has increased. The Clinical Frailty Scale (CFS) is a validated tool for assessing frailty, and higher scores indicate worse clinical outcomes following cardiovascular procedures. This retrospective study aimed to examine preoperative frailty in relation to recurrence and mortality following curative resection of colorectal cancer. METHODS: We retrospectively analyzed data for 729 consecutive patients undergoing curative resection of stage I–stage III colon and rectal adenocarcinoma between January 2009 and December 2016. Frailty was assessed using the CFS: 1 (very fit) to 9 (terminally ill), and frailty was defined as CFS ≥ 4. Recurrence‐free survival (RFS) and overall survival (OS) were compared between frail and nonfrail patients. Cox proportional hazards model was used to calculate hazard ratios (HRs), controlling for potential confounders. RESULTS: CFS score was negatively correlated with the Barthel index of activities of daily living (Spearman's ρ = −0.83). Of the 729 patients, 253 (35%) were frail. In multivariable analyses adjusting for potential confounders including age and disease stage, frailty was independently associated with shorter RFS (multivariable HR: 1.70, 95% confidence interval: 1.25‐2.31, P < .001) and OS (multivariable HR: 2.04, 95% confidence interval: 1.40‐2.99, P < .001). There were no significant interactions of frailty with age and disease stage regarding RFS and OS (P (interaction) > .72). CONCLUSION: Preoperative frailty was independently associated with shorter RFS and OS following resection of nonmetastatic colorectal cancer, regardless of age and disease stage. Further trials are needed to establish treatment strategies for frail patients with colorectal cancer. John Wiley and Sons Inc. 2020-04-19 /pmc/articles/PMC7382441/ /pubmed/32724884 http://dx.doi.org/10.1002/ags3.12337 Text en © 2020 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Mima, Kosuke
Miyanari, Nobutomo
Morito, Atsushi
Yumoto, Shinsei
Matsumoto, Takashi
Kosumi, Keisuke
Inoue, Mitsuhiro
Mizumoto, Takao
Kubota, Tatsuo
Baba, Hideo
Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer
title Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer
title_full Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer
title_fullStr Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer
title_full_unstemmed Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer
title_short Frailty is an independent risk factor for recurrence and mortality following curative resection of stage I–III colorectal cancer
title_sort frailty is an independent risk factor for recurrence and mortality following curative resection of stage i–iii colorectal cancer
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382441/
https://www.ncbi.nlm.nih.gov/pubmed/32724884
http://dx.doi.org/10.1002/ags3.12337
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