BACKGROUND: Frailty has been proposed by geriatricians as an indicator of functional age. The Edmonton Frail Scale (EFS) is a 15-point incremental scale; it is quick (<5 min), and simple to administer. We conducted an exploratory study to establish if the EFS add utility to clinician's expertise by determining if there was an association between EFS and receipt of chemotherapy in colorectal cancer (CRC) patients. METHODS: The EFS was administered to stage II-IV CRC patients ≥70 years. EFS assessment was completed by one of the investigators, with the treating oncology team blinded to the results. RESULTS: A total of 46 patients were enrolled, and the EFS was reproduced in 32 patients at two visits (r=0.81; 95% CI: 0.64-0.90, P<0.0001). There was no correlation between the EFS and receipt of chemotherapy for the study population as a whole; however, exclusion of stage II patients showed a reduced likelihood of receiving chemotherapy with higher EFS scores (odds ratio 0.56; 95% CI: 0.37-0.85, P<0.01 per unit increment). A similar effect was observed after multivariable analysis (adjusting for performance status, age, stage and gender, odds ratio 0.41 95% CI: 0.18-0.96, P<0.05 per unit increment). CONCLUSIONS: This exploratory study suggests that EFS can identify patients that oncologists may have thought were too frail for chemotherapy, independent of PS. Therefore, the EFS has the potential to add a reproducible, and quantifiable measure of frailty to the clinician's decision making toolset. A follow up study will employ the EFS in real-time, and determine if using the EFS can minimize complications and unplanned health care utilization in elderly cancer patients.
BACKGROUND: Frailty has been proposed by geriatricians as an indicator of functional age. The Edmonton Frail Scale (EFS) is a 15-point incremental scale; it is quick (<5 min), and simple to administer. We conducted an exploratory study to establish if the EFS add utility to clinician's expertise by determining if there was an association between EFS and receipt of chemotherapy in colorectal cancer (CRC) patients. METHODS: The EFS was administered to stage II-IV CRCpatients ≥70 years. EFS assessment was completed by one of the investigators, with the treating oncology team blinded to the results. RESULTS: A total of 46 patients were enrolled, and the EFS was reproduced in 32 patients at two visits (r=0.81; 95% CI: 0.64-0.90, P<0.0001). There was no correlation between the EFS and receipt of chemotherapy for the study population as a whole; however, exclusion of stage II patients showed a reduced likelihood of receiving chemotherapy with higher EFS scores (odds ratio 0.56; 95% CI: 0.37-0.85, P<0.01 per unit increment). A similar effect was observed after multivariable analysis (adjusting for performance status, age, stage and gender, odds ratio 0.41 95% CI: 0.18-0.96, P<0.05 per unit increment). CONCLUSIONS: This exploratory study suggests that EFS can identify patients that oncologists may have thought were too frail for chemotherapy, independent of PS. Therefore, the EFS has the potential to add a reproducible, and quantifiable measure of frailty to the clinician's decision making toolset. A follow up study will employ the EFS in real-time, and determine if using the EFS can minimize complications and unplanned health care utilization in elderly cancerpatients.
Entities:
Keywords:
Elderly; chemotherapy; colorectal cancer (CRC); frailty; geriatrics
Authors: Ab A Aaldriks; Lydia G M van der Geest; Erik J Giltay; Saskia le Cessie; Johanneke E A Portielje; Bea C Tanis; Johan W R Nortier; Ed Maartense Journal: J Geriatr Oncol Date: 2013-04-30 Impact factor: 3.599
Authors: Paolo Maione; Francesco Perrone; Ciro Gallo; Luigi Manzione; FrancoVito Piantedosi; Santi Barbera; Silvio Cigolari; Francesco Rosetti; Elena Piazza; Sergio Federico Robbiati; Oscar Bertetto; Silvia Novello; Maria Rita Migliorino; Adolfo Favaretto; Mario Spatafora; Francesco Ferraù; Luciano Frontini; Alessandra Bearz; Lazzaro Repetto; Cesare Gridelli; Emiddio Barletta; Maria Luisa Barzelloni; Rosario Vincenzo Iaffaioli; Ermelinda De Maio; Massimo Di Maio; Gianfranco De Feo; Giuseppe Sigoriello; Paolo Chiodini; Angela Cioffi; Vincenzo Guardasole; Valentina Angelini; Antonio Rossi; Domenico Bilancia; Domenico Germano; Alfredo Lamberti; Vittorio Pontillo; Luigi Brancaccio; Francesco Renda; Francesco Romano; Gabriella Esani; Anna Gambaro; Orazio Vinante; Giuseppe Azzarello; Maurizia Clerici; Roberto Bollina; Paolo Belloni; Mirella Sannicolò; Libero Ciuffreda; Giuseppe Parello; Mary Cabiddu; Cosimo Sacco; Angela Sibau; Gianfranco Porcile; Federico Castiglione; Oliviero Ostellino; Silvio Monfardini; Micaela Stefani; Giorgio Scagliotti; Giovanni Selvaggi; Filippo De Marinis; Olga Martelli; Giampietro Gasparini; Alessandro Morabito; Domenico Gattuso; Giuseppe Colucci; Domenico Galetta; Francesco Giotta; Vittorio Gebbia; Nicola Borsellino; Antonio Testa; Emilia Malaponte; Matteo A Capuano; Michele Angiolillo; Francesco Sollitto; Umberto Tirelli; Simona Spazzapan; Vincenzo Adamo; Giuseppe Altavilla; Antonio Scimone; Maria Raffaella Hopps; Francesco Tartamella; Giovanni Pietro Ianniello; Vincenza Tinessa; Giuseppe Failla; Roberto Bordonaro; Nicola Gebbia; Maria Rosaria Valerio; Modesto D'Aprile; Enzo Veltri; Maurizio Tonato; Samir Darwish; Sante Romito; Francesco Carrozza; Sandro Barni; Antonio Ardizzoia; Giuliana Mara Corradini; Gianfranco Pavia; Mario Belli; Giuseppe Colantuoni; Enzo Galligioni; Orazio Caffo; Roberto Labianca; Antonello Quadri; Enrico Cortesi; Giuliana D'Auria; Sergio Fava; Anna Calcagno; Gino Luporini; M Cristina Locatelli; Francesco Di Costanzo; Silvia Gasperoni; Luciano Isa; Paola Candido; Fernando Gaion; Giovanni Palazzolo; Giuseppe Nettis; Anselmo Annamaria; Massimo Rinaldi; Massimo Lopez; Raffaella Felletti; Giorgio Bernabò Di Negro; Nestore Rossi; Antonio Calandriello; Luigi Maiorino; Rodolfo Mattioli; Alfredo Celano; Stefania Schiavon; Alfonso Illiano; Carlo Alberto Raucci; Michele Caruso; Paolo Foa; Giuseppe Tonini; Carlo Curcio; Marina Cazzaniga Journal: J Clin Oncol Date: 2005-10-01 Impact factor: 44.544
Authors: M E Tinetti; D I Baker; G McAvay; E B Claus; P Garrett; M Gottschalk; M L Koch; K Trainor; R I Horwitz Journal: N Engl J Med Date: 1994-09-29 Impact factor: 91.245
Authors: Simon J G Richards; Frank A Frizelle; John A Geddes; Tim W Eglinton; Mark B Hampton Journal: Int J Colorectal Dis Date: 2018-09-14 Impact factor: 2.571
Authors: J Knight; K Ayyash; K Colling; J Dhesi; V Ewan; G Danjoux; E Kothmann; A Mill; S Taylor; D Yates; Reema Ayyash Journal: BMC Geriatr Date: 2020-08-27 Impact factor: 3.921