Frailty in Elderly Gastric Cancer Patients Undergoing Gastrectomy

Abstract

<b><i>Introduction:</i></b> There is a dearth of literature on frailty specifically in elderly (aged ≥65 years) gastric cancer patients undergoing gastrectomy. We aim to assess the effects of frailty on postoperative outcomes. <b><i>Methods:</i></b> A review of a prospective database was performed from November 2011 to April 2019. Frailty was assessed by multidimensional frailty score (MFS). Outcomes assessed were early postoperative complications and mortality, and length of stay. <b><i>Results:</i></b> 289 patients were included. The mean age was 77.3 (range 66–94) years. 183 (63.3%) were males and 172 (59.5%) had early cancer. 275 (95.2%) underwent minimally invasive gastrectomy. 79 (27.3%) patients suffered early postoperative complications, with 47 (16.3%) suffering from Clavien-Dindo grade ≥2 complications. One-year, 90-day, 30-day, and inhospital mortality were 6.6, 1.4, 0.7, and 0%, respectively. 111 (38.4%) of patients were classified as “frail” based on MFS > 5. “Frail” patients were associated with higher 1-year mortality (odds ratio (OR) 4.51, 95% CI 1.57–12.98, <i>p</i> = 0.005) on univariate analysis. On multivariate analysis, “frail” patients did not have significantly increased 1-year mortality. However, when definition of “frail” was changed from MFS > 5 to MFS > 6, frailty was significantly associated with increased 1-year mortality (OR 3.73, 95% CI 1.11–12.53, <i>p</i> = 0.033). <b><i>Conclusions:</i></b> Elderly gastric cancer patients undergoing gastrectomy with MFS > 5 do not have increased mortality risk. The influence of frailty on postoperative outcomes may vary based on the risk of the surgical procedure.

Electrical Line Fault Detection and Line Cut-Off Equipment and Control

“…However, since the cable is laid below the ground, in the cable tunnel, channel, and pipe row, when the fault occurs, the maintenance personnel cannot directly observe the fault point. e fault location needs to be carried out in advance, and then the covering on the cable fault point can be removed for maintenance [2]. erefore, the accuracy of cable positioning will directly determine the time of troubleshooting.…”

Impact of frailty on survival and readmission in patients with gastric cancer undergoing gastrectomy: A meta-analysis

“…Two articles (12,23) were obtained from the same population and reported the different clinical outcomes. Finally, eight studies reported on nine articles (12,13,(15)(16)(17)(18)(23)(24)(25) were included in the meta-analysis (Figure 1).…”

“…An early systematic review only described the association between frailty and adverse outcomes in patients with gastric cancer undergoing gastrectomy (11). Subsequently, several new articles (12)(13)(14)(15)(16)(17) that investigated the predictive utility of frailty in patients with gastric cancer have pursued a meta-analysis that applies accumulating clinical evidence. Nevertheless, the value of the frailty in predicting overall survival remains conflicting in patients with gastric cancer (17,18).…”

Prognostic impact of frailty after gastrectomy in elderly gastric cancer patients

“…It can predict the patient's response after surgery. In GC, frailty was associated with both the short-and long-term outcomes [11][12][13]. Tanaka et al reported that frailty increased systemic postoperative complications, and frailty and leanness were signi cant prognostic factors.…”

“…We previously reported the signi cance of frailty in elderly hepatocellular carcinoma patients after hepatectomy and in pancreatic ductal adenocarcinoma patients following pancreatectomy [9,10]. By contrast, little is known about the clinical impact of frailty in GC [11][12][13].…”