Frailty and aging in cancer survivors

Ness, Kirsten K.; Wogksch, Matthew D.

doi:10.1016/j.trsl.2020.03.013

Cited by 66 publications

(62 citation statements)

References 102 publications

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“…Our review suggested that frailty was associated with prognosis of lung cancer, which was in accordance with those of studies conducted in patients with other type of cancer (7,8). However, based on one study included in our metaanalysis, frailty seemed not to be associated with postoperative complications in lung cancer patients, which was not consistent with relevant results of studies on other types of cancer.…”

Section: Discussionsupporting

confidence: 72%

“…17.4% of community-dwelling adults ages 60 years and older present with frailty, 49.3% with prefrailty, while that incidence increases to 29.5 and 59.3% respectively in those ages 85 years and older (6). The prevalence of frailty in patients with cancer is especially high (7), and it has been reported that more than half of older patients with cancer are frail at cancer diagnosis, which may increase the risk of chemotherapy intolerance, postoperative complications, and mortality (8).…”

Section: Introductionmentioning

confidence: 99%

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Impacts of Frailty on Prognosis in Lung Cancer Patients: A Systematic Review and Meta-Analysis

et al. 2021

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Background: Frailty is a common geriatric syndrome and is described as a limited ability to compensate and recover from stressors. Lung cancer is largely diagnosed in old age, when frailty is common and might have predictive value on prognosis. Therefore, we performed a systematic review to evaluate the prognostic role of frailty in lung cancer.Methods: The online PubMed, Web of Science, CNKI and Wanfang literature databases were searched to identify all related articles that reported the predictive value of frailty for mortality and therapeutic toxicity. Review Manager 5.3 was used to analyze results by standard meta-analysis methodology.Results: Seven studies were included in this review, and only six studies with 2,359 patients were enrolled in meta-analysis. Patients in two studies received chemotherapy, two studies radiotherapy, two studies surgery, one study not reported. Compared to non-frail patients, frail patients had a higher risk of overall mortality [Hazard Ratio (HR) = 1.57, 95% confidence interval (CI), 1.32–1.87], and therapeutic toxicity [Odds Ratio (OR) = 2.60, 95% CI, 0.82–8.24]. Prefrail patients also showed higher overall mortality and therapeutic toxicity than non-frail patients (HR = 1.20, 95% CI, 1.05–1.38; OR = 1.72, 95% CI, 1.18–2.51, respectively).Conclusions: Frailty is a powerful predictor of overall mortality and therapeutic toxicity in lung cancer patients.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Impacts of Frailty on Prognosis in Lung Cancer Patients: A Systematic Review and Meta-Analysis

et al. 2021

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“…General population studies were eligible if the sample size was roughly 250 or larger and if 75% or more of this population was below 65 years of age, as they have comparable levels of frailty to a young adult survivor population. 5 , 7 , 8 We excluded studies with older adults since they are expected to have higher levels of frailty, comorbidities, and aging factors, which may be confounders in the correlation between the newer biomarker and the metabolic syndrome. Multivariable analysis was mandatory for article inclusion of studies that investigated the prediction of MetS.…”

Section: Methodsmentioning

confidence: 99%

“…Consequently, survivors with an actual mean age of 33 have a biological age of 65 if they are compared with the general population. 4 , 5 , 6 , 7 , 8 , 9 At the age of 45–50 years, the prevalence of any chronic health condition is very high, from 95% up to 99%. 3 , 10 One of these severe conditions is represented by cardiovascular disease (CVD), which is an important cause of premature death beyond 5 years cancer survival; the standardized mortality risk for CVD ranges from 1.9 to 12.7.…”

Section: Introductionmentioning

confidence: 99%

Can biomarkers be used to improve diagnosis and prediction of metabolic syndrome in childhood cancer survivors? A systematic review

et al. 2021

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Childhood cancer survivors (CCS) are at increased risk to develop metabolic syndrome (MetS), diabetes, and cardiovascular disease. Common criteria underestimate adiposity and possibly underdiagnose MetS, particularly after abdominal radiotherapy. A systematic literature review and meta-analysis on the diagnostic and predictive value of nine newer MetS related biomarkers (adiponectin, leptin, uric acid, hsCRP, TNF-alpha, IL-1, IL-6, apolipoprotein B (apoB), and lipoprotein(a) [lp(a)]) in survivors and adult non-cancer survivors was performed by searching PubMed and Embase. Evidence was summarized with GRADE after risk of bias evaluation (QUADAS-2/QUIPS). Eligible studies on promising biomarkers were pooled. We identified 175 general population and five CCS studies. In the general population, valuable predictive biomarkers are uric acid, adiponectin, hsCRP and apoB (high level of evidence), and leptin (moderate level of evidence). Valuable diagnostic biomarkers are hsCRP, adiponectin, uric acid, and leptin (low, low, moderate, and high level of evidence, respectively). Meta-analysis showed OR for hyperuricemia of 2.94 (age-/ sex-adjusted), OR per unit uric acid increase of 1.086 (unadjusted), and AUC for hsCRP of 0.71 (unadjusted). Uric acid, adiponectin, hsCRP, leptin, and apoB can be alternative biomarkers in the screening setting for MetS in survivors, to enhance early identification of those at high risk of subsequent complications.

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“…In the previously mentioned studies, excepting the multinational study, the sample size and follow-up time were shorter, and they did not include relevant confounders such as falls, nutritional status and disability in the adjusted regression model, as in this study. This variables have been described as relevant predictors of mortality in older adults with cancer [40,41].…”

Section: Comparison With Literaturementioning

confidence: 99%

Gait speed as a predictor of mortality in older men with cancer: A longitudinal study in Peru

Salazar

Barrueto-Deza

Urrunaga-Pastor

et al. 2022

Heliyon

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Background: Given the increase in incidence and mortality from cancer in recent years in Latin America and Peru, it is necessary to identify frailty older adults at higher risk of disability, hospitalizations and mortality. However, its measure is complex and requires time. For this reason, it has been proposed that frailty can be evaluated by a single measure, as gait speed. We aimed to evaluate the role of gait speed as a predictor of mortality in older men with cancer in Peru. Methods: A prospective cohort study was carried out that included military veterans (aged 60 years and older) with an oncological diagnosis evaluated at the Centro M edico Naval in Peru during the period 2013-2015. Slow gait speed was defined as <0.8 m/s. All-cause mortality was recorded during a 2-year follow-up. Sociodemographic characteristics, medical and personal history, and functional assessment measures were collected. We performed Cox regression analysis to calculate hazard ratios with their respective 95% confidence intervals. Results: 922 older men were analyzed from 2013 to 2015, 56.9% (n ¼ 525) of whom were >70 years of age. 41.3% (n ¼ 381) had slow gait speed with a mortality incidence of 22.9% (n ¼ 211) at the end of follow-up. The most frequent types of cancer in the participants who died were of the lung and airways (26.1%), liver and bile ducts (23.2%), and lymphomas and leukemias (16.6%). In the adjusted Cox regression analysis, we found that slow gait speed was a risk factor for mortality in older men with cancer (adjusted hazard ratio ¼ 1.55; 95% confidence interval: 1.21-2.23). Conclusions: Slow gait speed was associated with an increased risk of mortality in older men with cancer. Gait speed could represent a simple, useful, inexpensive, rapidly applicable marker of frailty for the identification of older men at higher risk of mortality. Gait speed could be useful in low-and middle-income countries, and in rural areas with limited access to health services.

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Frailty and aging in cancer survivors

Cited by 66 publications

References 102 publications

Impacts of Frailty on Prognosis in Lung Cancer Patients: A Systematic Review and Meta-Analysis

Impacts of Frailty on Prognosis in Lung Cancer Patients: A Systematic Review and Meta-Analysis

Can biomarkers be used to improve diagnosis and prediction of metabolic syndrome in childhood cancer survivors? A systematic review

Gait speed as a predictor of mortality in older men with cancer: A longitudinal study in Peru

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