The gap of frailty value from a community-dwelling population predict oncological outcomes in patients with urological cancers

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cancer in Special Situations
Genitourinary Cancers
Presenter Shingo Hatakeyama
Citation Annals of Oncology (2018) 29 (suppl_9): ix74-ix78. 10.1093/annonc/mdy435
Authors S. Hatakeyama1, S. Konishi2, K. Okita1, O. Soma1, T. Matsumoto1, T. Yoneyama1, Y. Hashimoto1, T. Koie1, C. Ohyama1
  • 1Urology, Hirosaki Univ. School of Med., 036-8560 - Hirosaki/JP
  • 2Urology, Hirosaki Univ. School of Med., 036-8562 - Hirosaki/JP

Abstract

Background

As a quantitative frailty evaluation in cancer patients remains challenging, we investigated whether the gap of frailty values between community-dwelling population and tumor-bearing cancer patients predict prognosis in patients with urological cancer.

Methods

Frailty assessment was performed in 521 cancer patients presenting to our university hospital between August 2013 to March 2016. Frailty was assessed using a validated tool that included 1) physical capabilities, 2) serum biochemical test, and 3) exhaustion. Age and sex adjusted estimated healthy values were determined by linear regression analysis from 1090 community-dwelling healthy subjects (HLT) who underwent frailty assessment. The gap of frailty values: [(estimated – actual)/estimated] was regarded as a frailty gap (%), and the total frailty gap was established by adding each frailty gap. We retrospectively compared total frailty gap between HLT and cancer patients. Total frailty gap < 20% were classified non-frail, 20-100% were mild-frail, 100-170% were moderate-frail, and > 170% were severe-frail. Independent factors that were significantly associated with overall survival in cancer patients were evaluated by multivariate regression analysis.

Results

Urological cancer included bladder cancer (n = 143), prostate cancer (n = 232), renal cell carcinoma (n = 90), and upper tract urothelial carcinoma (n = 56). Median total frailty gap in HLT and patient with urological cancer were -3% and 97%, respectively. Severe-frail were significantly associated with poor overall survival. Multivariate Cox regression analysis showed metastatic disease, and total frailty gap were selected as independent predictors for poor prognosis in patients with urological cancers. Limitations of the present study were retrospective nature and a need for further validation study.

Conclusions

Quantitative evaluation of frailty gap independently predicts overall survival in patients with urological cancers. Assessing frailty can help patients and physicians make more informed decisions.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Shingo Hatakeyama.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.