Use of the Rockwood Clinical Frailty Scale in patients with advanced hepatopancreaticobiliary malignancies
Shah, Dinakshi Kapacee, Zainul Abedin Lamarca, Angela Hubner, Richard A Valle, Juan W McNamara, Mairead G
Shah, Dinakshi
Kapacee, Zainul Abedin
Lamarca, Angela
Hubner, Richard A
Valle, Juan W
McNamara, Mairead G
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Abstract
Background: Co-existing frailty in older patients with hepatopancreaticobiliary (HPB) malignancies is common. This study assessed the relationship between the Rockwood Clinical Frailty scale (CFS) and systemic anti-cancer therapy dose intensity (SACT-DI) and overall survival (OS) in patients with advanced HPB malignancies.
Research design and methods: CFS was assessed prospectively for consecutive patients with newly diagnosed advanced HPB malignancy (The Christie; Sep-2019 to June-2020). Mann-Whitney U test assessed association between CFS, ECOG Performance Status (ECOG PS), and SACT-DI and Spearman's rank assessed the association between ECOG PS, age, and frailty. Survival analysis was performed using Kaplan-Meier and Cox regression.
Results: Two hundred patients met inclusion criteria. SACT-DI was higher in Group-1 (not frail) (CFS 1-3)(median = 61%) than Group-2 (vulnerable/mildly frail) (CFS 4-5)(median = 25.1%), p < 0.001. Median OS was shorter in frail and pre-frail patients (HR 2.3(95%CI 1.8-2.9),p < 0.001. On multivariable analysis, both CFS (HR 1.5-(95%CI 1.2-1.9), p = 0.002) and ECOG PS (HR 1.9 (95%CI 1.6-2.3), p < 0.001) were independent prognostic factors for OS.
Conclusion: Frailty assessments, in addition to ECOG PS, may identify patients that will benefit from systemic therapy and are both independent prognostic factors for OS.
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Date
2022
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Collections
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Article
Citation
Shah D, Kapacee ZA, Lamarca A, Hubner RA, Valle JW, McNamara MG. Use of the Rockwood Clinical Frailty Scale in patients with advanced hepatopancreaticobiliary malignancies. Expert Rev Anticancer Ther. 2022 Jul 6:1-7. PubMed PMID: 35768183. Epub 2022/06/30. eng.