The Frailty Based on the Memorial Sloan Kettering Frailty Index for Prediction of Surgical Outcome in Advance Epithelial Ovarian Cancer—Experience of a Single Center in Mexico

• Published in: Indian journal of surgical oncology 2022-06, Vol.13 (2), p.426-431
• Main Authors: Aguilar-Frasco, Jorge L., Armillas-Canseco, Francisco, Rivera-Sánchez, Fernanda, Moctezuma-Velázquez, Paulina, Moctezuma-Velázquez, Carlos, Castro, Emma, Pastor-Sifuentes, Francisco U., Hernández-Gaytán, Cristian Axel, Alfaro-Goldaracena, Alejandro, Medina-Franco, Heriberto
• Format: Article
• Language: English
• Subjects: Cancer surgery; Frailty; Medical records; Medicine; Medicine & Public Health; Oncology; Original; Original Article; Ovarian cancer; Surgery; Surgical Oncology
• ISSN: 0975-7651; 0976-6952
• DOI: 10.1007/s13193-022-01499-6

Retrospective impact evaluation of frailty as measured by the Memorial Sloan Kettering Frailty Index (MSK-FI) on outcomes in older women surgically treated for advanced epithelial ovarian cancer (EOC). Women ≥ 60 years with stage IIIC/IV EOC who underwent primary debulking surgery (PDS) or interval debulking surgery (IDS) were included. Medical records were reviewed for patients’ characteristics and outcomes. We retrospectively applied the MSK-FI which included 10 comorbidities and functional assessment that were extracted from medical records. The MSK-FI ranges from 0 to 11; a score of ≥ 3 was considered frail. Associations were assessed using logistic regression and Cox proportional hazards regression. We identified 79 patients treated with PDS ( n  = 36, 45.5%) or IDS ( n  = 43, 54.4%) with complete data. The prevalence of frailty based on MSK-FI was 25%. Almost half of the frail patients (47.3%) were admitted to the ICU compared to 16% of non-frail patients ( p  = 0.006). In univariable analysis, the MSK-FI was associated with postoperative complications [OR 1.57 (95% CI 1.04–2.37), p  = 0.03] and ICU admission [OR 2.05 (95% CI 1.30–3.23), p  = 0.002], but not with readmission rate [OR 1.29 (95% CI 0.65–2.59), p  = 0.5], postoperative mortality [OR 1.02 (95% CI 0.51–2.00), p  = 0.9], and hospital stay [β 0.60 (95% CI − 1.19–2.41)]. In multivariable analysis, the frailty index was independently associated with postoperative complications [OR 1.54 (95% CI 1.02–2.34), p  = 0.04] and ICU admissions [OR 1.97 (95% CI 1.23–3.16), p  = 0.004]. Frailty, based on the Memorial Sloan Kettering Frailty Index, is associated with adverse postoperative outcomes in older women with advanced ovarian cancer, suggesting that MSK-FI can improve the predictive ability of current surgical assessment tools.