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

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. We retrospectively applied the MSK-FI to women ≥70 years with newly diagnosed advanced-stage ovarian cancer surgically trea...

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Bibliographic Details
Published in:Gynecologic oncology 2021-06, Vol.161 (3), p.687-692
Main Authors: Filippova, Olga T., Tin, Amy L., Alonso, Joanne, Vickers, Andrew J., Tew, William P., Gardner, Ginger J., Sonoda, Yukio, Roche, Kara Long, Zivanovic, Oliver, Chi, Dennis S., Shahrokni, Armin
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoma, Ovarian Epithelial - mortality
Carcinoma, Ovarian Epithelial - pathology
Carcinoma, Ovarian Epithelial - surgery
Clinical Decision-Making
Cytoreduction Surgical Procedures
Female
Frail Elderly
Frailty
Frailty index
Humans
MSK-FI
Neoadjuvant chemotherapy
Neoplasm Metastasis
New York
Ovarian cancer
Ovarian Neoplasms - mortality
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
Retrospective Studies
Surgery
Survival Analysis
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Summary: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. 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. 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 
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2021.03.016