Abstract
Introduction
A modified 5-item frailty index was recently developed as a predictor of patient comorbidity-based
mortality and morbidity. We evaluate the association between preoperative modified
5-item frailty index score and prognosis after radical cystectomy for bladder cancer.
Patients and Methods
In this multicenter retrospective study, we calculated modified 5-item frailty index
scores of the 238 patients that underwent radical cystectomy for bladder cancer between
March 2009, and March 2018. The patients were classified into high frailty index score
(≥ 2) or low frailty index score (≤ 1) groups for comparison of overall and cancer-specific
survival between them. To evaluate the prognostic impact of the preoperative frailty
index, we also performed Cox proportional regression analyses for overall, and cancer-specific
survival.
Results
Of 238 patients, 53 patients were classified into the high frailty index score group
and 185 patients into the low frailty index score group. Overall, 70 patients died
of bladder cancer (29%), and 21 patients died of other causes (9%). The patients with
high frailty index score had significantly lower rate of overall survival than those
with low frailty index score (P < .01). On the other hand, there was no significant difference in cancer-specific survival
rate between the 2 groups (P = .07). Multivariable Cox proportional hazard analysis revealed that high modified 5-item
frailty index score was independently associated with poor overall survival (P = .01), but not with poor cancer-specific survival (P = .15).
Conclusion
High preoperative modified 5-item frailty index score could be a significant independent
predictor of poor prognosis after radical cystectomy in patients with bladder cancer.
Key Words
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Article info
Publication history
Published online: December 26, 2021
Accepted:
December 19,
2021
Received in revised form:
December 17,
2021
Received:
August 31,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
