Laura Orlandini1, Tiziano Nestola2, Giuseppe Ferdinando Colloca3, Alessandro Ferrini4, Matteo Cesari5,6. 1. Fellowship in Geriatrics and Gerontology, University of Milan, via Pace 9, 20122, Milan, Italy. 2. Fellowship in Geriatrics and Gerontology, University of Milan, via Pace 9, 20122, Milan, Italy. tiziano.nestola@yahoo.it. 3. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy. 4. Area di Geriatria, Policlinico Universitario Campus Biomedico, Rome, Italy. 5. Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 6. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Abstract
INTRODUCTION: Frailty is a key condition to be screened among elderly oncological patients. Aim of our work is to measure the functional and prognostic value for 1-year mortality of the Frailty Index (FI) in a cohort of older women with gynecological cancer. METHODS: The prognostic value of FI was tested in 200 older women with gynaecological cancer (mean age = 73.5 years). FI was retrospectively calculated following the Rockwood model. Spearman's rho test was used for correlations with other oncological scales: Eastern Cooperative Oncology Group Performance Status (ECOG); Karnofsky Performance Status (KPS); Vulnerable Elders Scale-13 (VES-13). Cox proportional hazard models and ROC curve were performed to estimate prognostic role of 1-year mortality. Sensitivity and specificity were also calculated. RESULTS: FI is normally distributed and descriptive statistics define our population as frail (mean = 0.25±0.11, range 0.08-0.51). 0.7 is confirmed as an upper limit compatible with life. FI does not significantly correlates with age, ECOG and KPS while it positively correlates with VES-13 (r = 0.7, p < 0.01). FI is the strongest predictor for 1-year mortality confirmed after all adjustments for confounders (OR 3.40; 95% CI 1.55-7.45, p < 0.01) and by ROC curve analyses (0.66, 95% CI 0.51-0.81, p = 0.01). CONCLUSIONS: Frailty Index is a useful tool to detect vulnerability in onco-geriatrics and it predicts 1-year mortality. Further studies are needed to confirm and extend these findings.
INTRODUCTION: Frailty is a key condition to be screened among elderly oncological patients. Aim of our work is to measure the functional and prognostic value for 1-year mortality of the Frailty Index (FI) in a cohort of older women with gynecological cancer. METHODS: The prognostic value of FI was tested in 200 older women with gynaecological cancer (mean age = 73.5 years). FI was retrospectively calculated following the Rockwood model. Spearman's rho test was used for correlations with other oncological scales: Eastern Cooperative Oncology Group Performance Status (ECOG); Karnofsky Performance Status (KPS); Vulnerable Elders Scale-13 (VES-13). Cox proportional hazard models and ROC curve were performed to estimate prognostic role of 1-year mortality. Sensitivity and specificity were also calculated. RESULTS: FI is normally distributed and descriptive statistics define our population as frail (mean = 0.25±0.11, range 0.08-0.51). 0.7 is confirmed as an upper limit compatible with life. FI does not significantly correlates with age, ECOG and KPS while it positively correlates with VES-13 (r = 0.7, p < 0.01). FI is the strongest predictor for 1-year mortality confirmed after all adjustments for confounders (OR 3.40; 95% CI 1.55-7.45, p < 0.01) and by ROC curve analyses (0.66, 95% CI 0.51-0.81, p = 0.01). CONCLUSIONS: Frailty Index is a useful tool to detect vulnerability in onco-geriatrics and it predicts 1-year mortality. Further studies are needed to confirm and extend these findings.