Preoperative modified frailty index to predict surgical complications in endometrial cancer patients

Abstract

To assess the predictive value of the preoperative modified frailty index (mFI) for postoperative complications in endometrial carcinoma, and to evaluate the risk factors associated with complications, and to compare the predictive properties of mFI with the American Society of Anesthesiologists (ASA) Physical Status classification. MethodsA total of 364 patients with endometrial cancer who underwent primary surgery between January 2009and December 2016 were examined. The prognostic value of mFI in predicting severe postoperative complications, assessed according to the Clavien-Dindo classification, was analyzed and compared with ASA status. The risk factors for adverse outcomes were determined using multivariate analysis. ResultsThe 30-day postoperative surgical-or medical-related complication rate was 26.6%. The rates of postoperative complications were 1.3%, 8.8%, 12.2%, and 60.0% for mFI scores of 0, 1, 2, and ≥3, respectively (P<0.001). The odds ratios for predicting postoperative complications in patients with mFI scores of 1, 2, and ≥3 were 7. 38, 10.59, and 114.75, respectively. In the multivariate analysis, the significant predictive factors for postoperative complications were mFI ≥1, body mass index (BMI) ≥30 kg/m 2 , and non-endometrioid cell type. At cut-off points of mFI ≥1 and ASA ≥2, both tools had similar sensitivities but mFI was more specific (sensitivities 92.9% vs. 100%; specificity 45.5% vs. 19.4%). ConclusionmFI provides a satisfactory predictive value for postoperative complications. Patients with an mFI score ≥1, a BMI ≥30 kg/m 2 , and a non-endometrioid subtype, are at risk of postoperative complications and should receive comprehensive preoperative and postoperative management.

Can the Modified Frailty Index (mFI) Predict Intraoperative and Postoperative Complications in Older Women with Endometrial Cancer Undergoing Laparoscopic or Robotic Surgery? A Multicenter Observational Study

“…Although the mFI has been widely adopted to evaluate frailty severity in elderly women with endometrial cancer [14,25,26], different frailty assessment tools such as the FFC (Fried frailty criteria), Johns Hopkins Adjusted Clinical Groups (ACG) frailty-defining diagnosis indicator, and a combination of different global health assessment tools have been seldom adopted [27][28][29][30][31].…”

Evaluating the Prognostic Factors and Survival Rates of Endometrial Cancer Patients in a Tertiary Referral Hospital in Northeast Thailand

“…The current standard of treatment for EC is surgery. The postoperative complication rate among patients with EC undergoing primary surgery is 16.2-37.9% [ 8 ]. Thailand boasts impressive health insurance schemes for its citizens.…”