Utility of the modified frailty index in predicting toxicity and cancer outcomes for older adults with advanced pancreatic cancer receiving first-line palliative chemotherapy

Rittberg, Rebekah; Zhang, Hanbo; Lambert, Pascal; Kudlovich, Robert; Kim, Christina; Dawe, David E.

doi:10.1016/j.jgo.2020.07.004

Cited by 9 publications

(5 citation statements)

References 35 publications

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“…A total of 310 articles were identified by the initial search (Figure 1), 43 manuscripts were retrieved for more detailed evaluation, and 18 studies [7,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] were finally included in the systematic review qualitative and quantitative analysis. Relevant data regarding mortality were reported in four studies.…”

Section: Resultsmentioning

confidence: 99%

The Prevalence and the Impact of Frailty in Hepato-Biliary Pancreatic Cancers: A Systematic Review and Meta-Analysis

Komici

Cappuccio

Scacchi

et al. 2022

JCM

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Background: Frailty has been associated with increased mortality among hepatobiliary pancreatic (HBP) cancer patients. Nevertheless, estimates of frailty prevalence in HBP cancers and the precise average effect regarding mortality remains uncertain. The present systematic review and meta-analysis aimed to quantify: (1) the prevalence of frailty in patients with liver and pancreatic cancers and (2) the impact of frailty on mortality in patients affected by liver and pancreatic cancers. Methods: MEDLINE/PubMed database search was conducted from inception until November 1st, 2021, the pooled prevalence and relative risk (RR) estimate were calculated. Results: A total of 34,276 patients were identified and the weighted prevalence of frailty was 39%; (95% [C.I.] 23–56; I2 = 99.9%, p < 0.0001). Frailty was significantly associated with increased mortality RR 1.98 (95% [C.I.] 1.49–2.63; I2 = 75.9%, p = 0.006). Conclusions: Frailty prevalence is common among HBP cancer patients and exerts a significant negative impact on survival. These findings are characterized by significant heterogeneity and caution is warranted on their interpretation. However, stratification of patients with HBP cancer by frailty status may provide prognostic information and may inform priorities for decision-making strategy.

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Section: Resultsmentioning

confidence: 99%

The Prevalence and the Impact of Frailty in Hepato-Biliary Pancreatic Cancers: A Systematic Review and Meta-Analysis

Komici

Cappuccio

Scacchi

et al. 2022

JCM

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“…In our dataset, there was no significant difference in patients with or without frailty in terms of CRT or survival. Rittberg et al [ 43 ] found that mFI-11-defined frailty in patients with advanced pancreatic cancer receiving first-line palliative chemotherapy was not associated with chemotherapy toxicity, disease response, or survival. Previous studies demonstrated that pre-frailty and frailty were high in older adults with cancer, up to 42% and 43%, respectively [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Sarcopenia, Frailty, and Inflammation on Adverse Events and Survival Outcomes in Patients with Oral Cavity Squamous Cell Carcinoma under Adjuvant Chemoradiotherapy

Huang

Chen

Lue

et al. 2021

JPM

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In this study, we aimed to evaluate the prognostic impact of sarcopenia, five-item modified frailty index (mFI-5), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) in patients with oral cavity squamous cell carcinoma (OSCC) treated with adjuvant chemoradiotherapy (CRT) and their survival outcomes. We retrospectively enrolled 175 patients with OSCC undergoing adjuvant CRT between 2011 and 2018, who were divided into groups with (n = 112) and without (n = 63) sarcopenia. Logistic regression analysis and Cox proportional hazards models were used to determine prognostic factors for CRT-related toxicity, three-year overall survival (OS), and disease-free survival (DFS). Sarcopenia and high PLR were independently associated with CRT-induced anemia (CIA); advanced tumor stage was related to poor three-year OS. CRT and survival did not differ by mFI-5 and NLR. Our results indicate that sarcopenia and high PLR are significant predictors of adjuvant CRT, increasing toxicity outcomes and indicating worse short-term OS. Accurately identifying sarcopenia and high PLR in patients with OSCC is critical to help better select candidates for adjuvant CRT to improve their outcomes.

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“…Rittberg et al examined the mFI in relation to outcomes of palliative chemotherapy in 87 patients with pancreatic cancer over 65 years of age. The authors found that frailty according to the mFI was not associated with the incidence of adverse events ( P > 0.16) or OS ( P = 0.60) during chemotherapy 78 . In a study by Ngo‐Huang, frailty based on the Fried Frailty Criteria was associated with shorter OS in patients with pancreatic cancer who underwent palliative chemotherapy ( P = 0.003), although they did not examine the associations between the Fried Frailty Criteria and adverse events during palliative chemotherapy 45 …”

Section: Chemotherapy In Frail Patients With Gastrointestinal Cancermentioning

confidence: 94%

“…The authors found that frailty according to the mFI was not associated with the incidence of adverse events (P > 0.16) or OS (P = 0.60) during chemotherapy. 78 In a study by Ngo-Huang, frailty based on the Fried Frailty Criteria was associated with shorter OS in patients with pancreatic cancer who underwent palliative chemotherapy (P = 0.003), although they did not examine the associations between the Fried Frailty Criteria and adverse events during palliative chemotherapy. 45 There are few previous studies on geriatric assessment and outcomes of chemotherapy in patients with gastrointestinal cancers.…”

Section: Effec Ts Of Pre-or Rehab Ilitation On Perioper Ative Outcome...mentioning

confidence: 99%

Frailty and surgical outcomes in gastrointestinal cancer: Integration of geriatric assessment and prehabilitation into surgical practice for vulnerable patients

Mima

Nakagawa

Miyata

et al. 2022

Annals of Gastroent Surgery

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As life expectancy increases, the older population continues to grow rapidly, resulting in increased requirement for surgery for older patients with gastrointestinal cancer. Older individuals represent a heterogeneous group in terms of physiological reserves, co‐morbidity, cognitive impairment, and disability. Owing to the lack of treatment guidelines for vulnerable patients with gastrointestinal cancer, these patients are more likely to be at risk of undertreatment or overtreatment. Hence, the identification of frail patients with gastrointestinal cancer would improve cancer treatment outcomes. Although there is no standardized geriatric assessment tool, a growing body of research has shown associations of frailty with adverse postoperative outcomes and poor prognosis after resection of gastrointestinal tract and hepatobiliary‐pancreatic cancers. Emerging evidence suggests that prehabilitation, which includes exercise and nutritional support, can improve preoperative functional capacity, postoperative recovery, and surgical outcomes, particularly in frail patients with gastrointestinal cancer. We reviewed major geriatric assessment tools for identification of frail patients and summarized clinical studies on frailty and surgical outcomes, as well as prehabilitation or rehabilitation in gastrointestinal tract and hepatobiliary‐pancreatic cancers. The integration of preoperative geriatric assessment and prehabilitation of frail patients in clinical practice may improve surgical outcomes. In addition, improving preoperative vulnerability and preventing functional decline after surgery is important in providing favorable long‐term survival in patients with gastrointestinal cancer. Further clinical trials are needed to examine the effects of minimally invasive surgery, and chemotherapy in frail patients with gastrointestinal cancer.

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Utility of the modified frailty index in predicting toxicity and cancer outcomes for older adults with advanced pancreatic cancer receiving first-line palliative chemotherapy

Cited by 9 publications

References 35 publications

The Prevalence and the Impact of Frailty in Hepato-Biliary Pancreatic Cancers: A Systematic Review and Meta-Analysis

The Prevalence and the Impact of Frailty in Hepato-Biliary Pancreatic Cancers: A Systematic Review and Meta-Analysis

Evaluation of Sarcopenia, Frailty, and Inflammation on Adverse Events and Survival Outcomes in Patients with Oral Cavity Squamous Cell Carcinoma under Adjuvant Chemoradiotherapy

Frailty and surgical outcomes in gastrointestinal cancer: Integration of geriatric assessment and prehabilitation into surgical practice for vulnerable patients

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