Frailty based on the Memorial Sloan Kettering Frailty Index is associated with surgical decision making, clinical trial participation, and overall survival among older women with ovarian cancer Journal Article
| Authors: | Filippova, O. T.; Tin, A. L.; Alonso, J.; Vickers, A. J.; Tew, W. P.; Gardner, G. J.; Sonoda, Y.; Long Roche, K.; Zivanovic, O.; Chi, D. S.; Shahrokni, A. |
| Article Title: | Frailty based on the Memorial Sloan Kettering Frailty Index is associated with surgical decision making, clinical trial participation, and overall survival among older women with ovarian cancer |
| Abstract: | Objectives: To determine whether the Memorial Sloan Kettering Frailty Index (MSK-FI) is associated with decision-making in older women surgically treated for advanced-stage ovarian cancer. Methods: We retrospectively applied the MSK-FI to women ≥70 years with newly diagnosed advanced-stage ovarian cancer surgically treated at our institution from 01/2001–05/2017. MSK-FI components, including 10 comorbidities and functional assessment, were extracted from medical records. The MSK-FI ranges from 0 to 11, with higher scores indicating greater frailty. The primary outcome was the association between frailty and rate of primary debulking surgery (PDS), for which a multivariable logistic regression was used, adjusted for stage and histology. Results: We identified 430 women treated with PDS (n = 231, 54%) or neoadjuvant chemotherapy/interval debulking (n = 199, 46%) with complete data. MSK-FI score distribution was: “0”, 95 patients (22%); “1”, 172 (40%); “2”, 89 (21%); and “3+”, 74 (17%). More-frail patients were less likely to have undergone PDS (OR for a unit increase of MSK-FI: 0.64; 95%CI, 0.53–0.77; p < 0.0001). Grade 3+ complications and unintended intensive care admission occurred in 40 (9%) and 38 (9%) women, respectively, but were not associated with frailty (OR 1.21; 95%CI, 0.96–1.52; p = 0.11). More-frail patients were more likely to delay postoperative chemotherapy (non-linear association p = 0.009) and less likely to enroll in research (OR 0.84; 95%CI, 0.70–1.00; p = 0.049). Greater frailty was associated with poorer overall survival (HR 1.16; 95%CI, 1.05–1.30; p = 0.005). Conclusions: Frailty, as calculated by the MSK-FI, is strongly associated with treatment approach in older women with advanced ovarian cancer, suggesting objective or subjective correlates of the MSK-FI influence decision-making. © 2021 Elsevier Inc. |
| Keywords: | ovarian cancer; surgery; neoadjuvant chemotherapy; frailty; frailty index; msk-fi |
| Journal Title: | Gynecologic Oncology |
| Volume: | 161 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-06-01 |
| Start Page: | 687 |
| End Page: | 692 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2021.03.016 |
| PUBMED: | 33773807 |
| PROVIDER: | scopus |
| PMCID: | PMC8164977 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 July 2021 -- Source: Scopus |
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