Frailty is associated with poor prognosis after resection for pancreatic cancer

Mima, Kosuke; Hayashi, Hiromitsu; Nakagawa, Shigeki; Matsumoto, Takashi; Kinoshita, Shotaro; Matsumura, Kazuki; Kitamura, Fumimasa; Uemura, Naomi; Nakao, Yosuke; Itoyama, Rumi; Kaida, Takayoshi; Imai, Katsunori; Yamashita, Yo‐ichi

doi:10.1007/s10147-021-01983-z

Cited by 26 publications

(16 citation statements)

References 49 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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“…Currently, the majority of surgical treatment decisions and frailty assessments of older patients with GBM are based on age, functional status, and general provider impression as opposed to more objective measures [ 25 , 26 ]. Frailty indexes have been useful for predicting postoperative complications in other cancer surgeries [ 27 , 28 ]. Using the Canadian Study on Health and Aging Modified Frailty Index (mFI) Cloney et al [ 29 ] conducted a retrospective analysis of 319 patients aged 65 or older with pathologically confirmed glioblastoma and assessed surgical outcomes.…”

Section: Current Glioblastoma Management In Older Adultsmentioning

confidence: 99%

Treatment of Older Adult Patients with Glioblastoma: Moving towards the Inclusion of a Comprehensive Geriatric Assessment for Guiding Management

Chahal¹,

Thiessen²,

Mariano³

2022

Current Oncology

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Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, and over half of patients with newly diagnosed GBM are over the age of 65. Management of glioblastoma in older patients includes maximal safe resection followed by either radiation, chemotherapy, or combined modality treatment. Despite recent advances in the treatment of older patients with GBM, survival is still only approximately 9 months compared to approximately 15 months for the general adult population, suggesting that further research is required to optimize management in the older population. The Comprehensive Geriatric Assessment (CGA) has been shown to have a prognostic and predictive role in the management of older patients with other cancers, and domains of the CGA have demonstrated an association with outcomes in GBM in retrospective studies. Furthermore, the CGA and other geriatric assessment tools are now starting to be prospectively investigated in older GBM populations. This review aims to outline current treatment strategies for older patients with GBM, explore the rationale for inclusion of geriatric assessment in GBM management, and highlight recent data investigating its implementation into practice.

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“…Neoadjuvant and adjuvant chemotherapy have been shown to improve prognosis in gastrointestinal cancer 79–83 . Mima et al reported that frail patients with colorectal and pancreatic cancers are less likely to receive adjuvant chemotherapy, which leads to poor prognosis 12,44,77,84 . Improvement of perioperative frailty would be key in providing favorable long‐term outcomes in patients with gastrointestinal cancers.…”

Section: Future Challenges and Conclusionmentioning

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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Frailty is associated with poor prognosis after resection for pancreatic cancer

Cited by 26 publications

References 49 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

Treatment of Older Adult Patients with Glioblastoma: Moving towards the Inclusion of a Comprehensive Geriatric Assessment for Guiding Management

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

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