Multidimensional Prognostic Index (MPI) score has the major impact on outcome prediction in elderly surgical patients with colorectal cancer: The FRAGIS study

Background This study aims (I) to evaluate whether the Multidimensional Prognostic Index (MPI) score is associated with postoperative outcomes and (II) to develop a prognostic model for individual complication‐risk prediction following colorectal cancer (CRC) surgery. Method This is a prospective mu...

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Published in:Journal of surgical oncology 2021-02, Vol.123 (2), p.667-675
Main Authors: Pata, Giacomo, Bianchetti, Luca, Rota, Matteo, Marengoni, Alessandra, Chiesa, Deborah, Cassinotti, Elisa, Palmisano, Silvia, Colombi, Marta, Del Zotto, Giulio, Romanelli, Giuseppe, Calza, Stefano, Boni, Luigi, De Manzini, Nicolò, Fumagalli Romario, Uberto
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Colorectal cancer
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Colorectal surgery
complication
Elective Surgical Procedures - mortality
Female
Follow-Up Studies
Frailty
geriatric assessment
Geriatric Assessment - methods
Humans
Male
multidimensional
Older people
Outcome Assessment, Health Care
Patient Selection
Postoperative Complications - mortality
Prognosis
Prospective Studies
Risk Assessment - methods
Risk Factors
Surgical outcomes
Survival Rate
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Summary:Background This study aims (I) to evaluate whether the Multidimensional Prognostic Index (MPI) score is associated with postoperative outcomes and (II) to develop a prognostic model for individual complication‐risk prediction following colorectal cancer (CRC) surgery. Method This is a prospective multicentric cohort study. Consecutive ≥75‐year‐old candidates for elective CRC surgery were enrolled from October 2017 to August 2019. Patients underwent standardized preoperative geriatric assessment including the MPI. Patients with MPI score > 0.33 were classified as frail. Logistic regression models were employed to evaluate variables associated with major postoperative complications and mortality, using 10‐fold cross‐validated LASSO (least absolute shrinkage and selection operator) for model selection. Results In all, 104 patients were included, 34 (33%) had MPI score > 0.33. Major postoperative complications occurred in 52% of frail versus 16% of fit (MPI score ≤ 0.33) patients (p 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.26314