Frailty Assessment for Outcome Prediction of Patients With Prostate Cancer Receiving Radical Prostatectomy: A Meta-Analysis of Cohort Studies

Abstract

A meta-analysis was conducted to investigate the association between frailty and postoperative complications in patients with prostate cancer following radical prostatectomy. A systematic search of PubMed, Embase, and Web of Science was conducted for relevant cohort studies. A random-effect model was chosen to combine the results. Five cohort studies including 171,929 patients were included. Results showed that patients with frailty had higher risk of severe postoperative complications (Clavien-Dindo IV complications, risk ratio [RR]: 1.87, 95% confidence interval [CI]: 1.67 to 2.10, p < .001; I² = 18%) and all-cause mortality (RR: 2.89, 95% CI: 1.86 to 4.50, p < 0.001; I² = 18%). Subgroup analyses showed consistent results in patients receiving open and robot-assisted radical prostatectomy, and also in studies with univariate and multivariate analyses. In conclusion, preoperative frailty may be a predictor of severe postoperative complications and all-cause mortality of patients with prostate cancer following radical prostatectomy.

Keywords: complications; frailty; meta-analysis; mortality; prostate cancer; prostatectomy.