Frailty in Patients With Lung Cancer

Komici, Klara; Bencivenga, Leonardo; Navani, Neal; D’Agnano, Vito; Guerra, Germano; Bianco, Angelica; Rengo, Giuseppe; Perrotta, Fabio

doi:10.1016/j.chest.2022.02.027

Cited by 67 publications

(34 citation statements)

References 56 publications

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“…Utilizing a scoring system for frailty assessment has the potential to improve postoperative outcomes and care [12]. Frailty may also predict mortality and treatment toxicity in many cancers [13][14][15][16]. However, the association between frailty and outcomes has not been well characterized in patients undergoing liver resection for ICC.…”

Section: Introductionmentioning

confidence: 99%

Impact of Frailty on Short-Term Outcomes of Hepatic Lobectomy in Patients with Intrahepatic Cholangiocarcinoma: Evidence from the US Nationwide Inpatient Sample 2005–2018

Xu,

Shao,

Huang

et al. 2024

Dig Surg

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Introduction: This study aimed to evaluate associations between frailty and outcomes in patients with ICC undergoing hepatic lobectomy using a large, nationally representative sample. Methods: This population-based, retrospective observational study extracted the data of adults ≥ 20 years old with ICC undergoing hepatic lobectomy from the US Nationwide Inpatient Sample (NIS) database between 2005 and 2018. Frailty was assessed by the validated Hospital Frailty Risk Score (HFRS). Associations between frailty and surgical outcomes were analyzed using logistic regression analyses. Results: After exclusions, 777 patients were enrolled, including 427 frail and 350 non-frail. Patients’ mean age was 64.5 (± 0.4) years and the majority were males (51.1%), and Whites (76.5%). Frailty was significantly associated with increased odds of in-hospital mortality (aOR: 18.51, 95%CI: 6.70, 51.18), non-home discharge (aOR: 3.58, 95%CI: 2.26, 5.66), prolonged LOS (aOR: 5.56, 95%CI: 3.87, 7.99), perioperative cardiac arrest/stroke (aOR: 5.44, 95%CI: 1.62, 18.24), acute respiratory distress syndrome (ARDS)/respiratory failure (aOR: 3.88, 95%CI: 2.40, 6.28), tracheostomy/ventilation (aOR: 3.83, 95%CI: 2.23, 6.58), bleeding/transfusion (aOR: 1.67, 95%CI: 1.24, 2.26), acute kidney injury (AKI) (aOR: 14.37, 95%CI: 7.13, 28.99), postoperative shock (aOR: 4.44, 95%CI: 2.54, 7.74), and sepsis (aOR: 11.94, 95%CI: 6.90, 20.67). Discussion/Conclusion: Among patients with ICC undergoing hepatic lobectomy, HFRS-defined frailty is a strong predictor of worse in-patient outcomes, including in-hospital death, prolonged LOS, unfavorable discharge, and complications (perioperative cardiac arrest/stroke, ARDS/respiratory failure, tracheostomy/ventilation, bleeding/transfusion, AKI, postoperative shock and sepsis). Study results may help stratify risk in frail patients undergoing hepatic resection for ICC.

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Section: Introductionmentioning

confidence: 99%

Impact of Frailty on Short-Term Outcomes of Hepatic Lobectomy in Patients with Intrahepatic Cholangiocarcinoma: Evidence from the US Nationwide Inpatient Sample 2005–2018

Xu,

Shao,

Huang

et al. 2024

Dig Surg

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“…Frailty is observed in 36.57%-45% of lung cancer patients, surpassing other cancer types. 6 Research indicates a bidirectional association between frailty and cognitive impairment in older adults. 7,8 The intricate and multifactorial nature of this relationship led to the formulation of cognitive frailty (CF) in 2013.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and a nomogram for predicting cognitive frailty in Chinese patients with lung cancer receiving drug therapy: A single‐center cross‐sectional study

Li,

Wang,

Zhai

et al. 2024

Thoracic Cancer

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BackgroundTo identify independent factors of cognitive frailty (CF) and construct a nomogram to predict cognitive frailty risk in patients with lung cancer receiving drug therapy.MethodsIn this cross‐sectional study, patients with lung cancer undergoing drug therapy from October 2022 to July 2023 were enrolled. The data collected includes general demographic characteristics, clinical data characteristics and assessment of tools for cognitive frailty and other factors. Logistic regression was harnessed to determine the influencing factors, R software was used to establish a nomogram model to predict the risk of cognitive frailty. The enhanced bootstrap method was employed for internal verification of the model. The performance of the nomogram was evaluated by using calibration curves, the area under the receiver operating characteristic curve, and decision curve analysis.ResultsA total of 372 patients were recruited, with a cognitive frailty prevalence of 56.2%. Age, education background, diabetes mellitus, insomnia, sarcopenia, and nutrition status were identified as independent factors. Then, a nomogram model was constructed and patients were classified into high‐ and low‐risk groups with a cutoff value of 0.552. The internal validation results revealed good concordance, calibration and discrimination. The decision curve analysis presented prominent clinical utility.ConclusionsThe prevalence of cognitive frailty was higher in lung cancer patients receiving drug therapy. The nomogram could identify the risk of cognitive frailty intuitively and simply in patients with lung cancer, so as to provide references for early screening and intervention for cognitive frailty at the early phases of drug treatment.

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“…Therefore, a growing number of patients present at diagnosis in their old age, with the pick in incidence at 75 years old (3)(4)(5). Moreover, the prevalence of frailty in NSCLC is 45% with a significant impact on survival (6).…”

Section: Introductionmentioning

confidence: 99%

Perioperative outcomes of robotic lobectomy for early-stage non-small cell lung cancer in elderly patients

et al. 2022

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IntroductionMinimally invasive surgery has become the standard for the early-stage non-small cell lung cancer (NSCLC). The appropriateness of the kind of lung resection for the elderly patients is still debated.MethodsWe retrospectively reviewed patients with older than 75 years who underwent robotic lobectomy between May 2016 to June 2022. We selected 103 patients who met the inclusion criteria of the study. The preoperative cardiorespiratory functional evaluations were collected, and the risk of postoperative complications was calculated according to the Charlson Comorbidity Index, the American College of Surgery surgical risk calculator (ACS-NSQIP), EVAD score, and American Society of Anesthesiology (ASA) score. The patients were divided in two groups according to the presence of postoperative complications.ResultsForty-three patients were female, and 72.8% of the total population were former or active smokers. Thirty-five patients reported postoperative complications. The analysis of the two groups showed that the predicted postoperative forced expiratory volumes in the first second (FEV1) and forced vital capacity (FVC) were significantly lower in patients presenting postoperative complications (p=0.04). Moreover, the upstaging rate and the unexpected nodal metastases were higher in the postoperative complication groups.ConclusionRobotic-assisted lobectomy for early-stage lung cancer is a safe and feasible approach in selected elderly patients. The factors that could predict the complication rate was the predicted postoperative FEV1 and the nodal disease.

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Frailty in Patients With Lung Cancer

Cited by 67 publications

References 56 publications

Impact of Frailty on Short-Term Outcomes of Hepatic Lobectomy in Patients with Intrahepatic Cholangiocarcinoma: Evidence from the US Nationwide Inpatient Sample 2005–2018

Impact of Frailty on Short-Term Outcomes of Hepatic Lobectomy in Patients with Intrahepatic Cholangiocarcinoma: Evidence from the US Nationwide Inpatient Sample 2005–2018

Risk factors and a nomogram for predicting cognitive frailty in Chinese patients with lung cancer receiving drug therapy: A single‐center cross‐sectional study

Perioperative outcomes of robotic lobectomy for early-stage non-small cell lung cancer in elderly patients

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