Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Jan 11;408(1):19.
doi: 10.1007/s00423-023-02754-2.

Preoperative frailty assessment in older patients with colorectal cancer: use of clinical and radiological tool

Jorge Luis Aguilar-Frasco  1 , Paulina Moctezuma-Velázquez  2 , Jorge Humberto Rodríguez-Quintero  3 , Emma Castro  2 , Francisco Armillas-Canseco  2 , Cristian Axel Hernández-Gaytán  2 , Francisco U Pastor-Sifuentes  4 , Carlos Moctezuma-Velázquez  2
Affiliations
Observational Study

Preoperative frailty assessment in older patients with colorectal cancer: use of clinical and radiological tool

Jorge Luis Aguilar-Frasco et al. Langenbecks Arch Surg. .

Erratum in

Abstract

Purpose: The Memorial Sloan Kattering Frailty Index (MSK-FI) and the Skeletal Muscle Index (SMI) have recently gained attention as markers of frailty and decreased physiologic reserve, and are promising as predictors of adverse postoperative outcomes in patients undergoing oncologic surgery. The objective of this study was to establish the prognostic accuracy of these indexes in a cohort of patients with colorectal cancer subjected to surgical intervention.

Methods: We performed an observational study including all patients older than 60 years, subjected to colorectal cancer surgery between January 2010 and May 2020, and stratified our cohort based on the presence of frailty, as defined by MSK-FI ≥ 3. Computed tomography was used to calculate SMI, using a standardized institutional protocol. A multivariable analysis was used to study the association between these novel indexes with adverse postoperative outcomes in our cohort.

Results: A total of 216 patients were included. Among these, 56 (26%) qualified as frail and 132 (62%) had a low SMI. On multivariable analysis (adjusted by patient and intraoperative characteristics), frailty was associated with increased risk of having a major postoperative complication (OR 29.78, 95%CI 10.36-85.71) and increased admission to the intensive care unit (OR 4.99, 95%CI 1.55-16.06), while both frailty and low SMI were associated with prolonged length of stay (OR 11.22, 95%CI 8.91-13.53 and OR 0.14, 95% CI 0.06-0.20, respectively).

Conclusion: MSK-FI ≥ 3 and low SMI are associated with adverse postoperative outcomes in elderly patients undergoing colorectal cancer surgery. Implementing this practical tool in routine clinical practice, may help identify patients that would benefit from surgical prehabilitation and preoperative optimization to improve outcomes.

Keywords: Colorectal surgery; Frailty; Frailty Index; MSK-FI; Sarcopenia; Skeletal Muscle Index.

PubMed Disclaimer

References

    1. Artiles-Armas M, Roque-Castellano C, Fariña-Castro R, Conde-Martel A, Acosta-Mérida MA, Marchena-Gómez J (2021) Impact of frailty on 5-year survival in patients older than 70 years undergoing colorectal surgery for cancer. World J Surg Oncol 19(106). https://doi.org/10.1186/s12957-021-02221-6
    1. González-Senac NM, Mayordomo-Cava J, Macías-Valle A, Aldama-Marín P, González SM, Arnés MLC, Vidán-Astiz MT, Serra-Rexach JA (2021) Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison. Int J Environ Res Public Health 18(11):6072. https://doi.org/10.3390/ijerph18116072
    1. Talarico L, Chen G, Pazdur R (2004) Enrollment of elderly patients in clinical trials for cancer drug registration: A 7-year experience by the US Food and Drug Administration. J Clin Oncol 22(22):4626–4631 - PubMed
    1. McMillan. The age old excuse: the under treatment of older cancer patients [Internet]. Vol. 1. 2012 [cited 2021 Dec 8]. Available from: www.macmillan.org.uk/Documents/GetInvolved/Campaigns/AgeOldExcuse/
    1. Aguilar-Frasco JL, Rodríguez-Quintero JH, Moctezuma-Velázquez P, Morales-Maza J, Moctezuma-Velázquez C, Pastor-Sifuentes F et al (2021) Frailty index as a predictive preoperative tool in the elder population undergoing major abdominal surgery: a prospective analysis of clinical utility. Langenbeck’s Arch Surg 406(4):1189–1198

Publication types

MeSH terms

LinkOut - more resources