PMID- 31076313
OWN - NLM
STAT- MEDLINE
DCOM- 20200817
LR  - 20200817
IS  - 1879-4076 (Electronic)
IS  - 1879-4068 (Linking)
VI  - 10
IP  - 5
DP  - 2019 Sep
TI  - Frailty assessment in elective gastrointestinal oncogeriatric surgery: Predictors 
      of one-year mortality and functional status.
PG  - 716-723
LID - S1879-4068(18)30344-8 [pii]
LID - 10.1016/j.jgo.2019.04.017 [doi]
AB  - OBJECTIVES: Perioperative frailty assessment is still a challenge, especially in 
      oncogeriatrics. We aimed at assessing the diagnostic accuracy of the 40 items 
      Frailty Index (FI) as compared to the comprehensive geriatric assessment (CGA) 
      for the prediction of one-year mortality and functional status after colorectal 
      surgery in old-age subjects. MATERIAL AND METHODS: Ninety-nine consecutive 
      patients aged 65 years or older who were candidate for elective gastrointestinal 
      cancer surgery, with G8 score </= 14 were enrolled and subjected to CGA and to 
      frailty stratification according to the 40-items FI. Long-term outcomes including 
      one-year mortality and functional decline were collected. RESULTS: Mean patient 
      age was 80.3 +/- 5.6 years. Colorectal cancer was the most common diagnosis. The 
      most prevalent clinical phenotype was pre-frail. CGA and FI showed similar 
      predictive accuracy in identifying one-year mortality after surgery and patient 
      functional status. Our multivariate analysis indicated the pre-morbid functional 
      status (IADL) and cancer stage as the most significant predictors of one-year 
      mortality. CONCLUSIONS: This is the first study to investigate the prognostic 
      accuracy of the 40-items FI as compared to CGA in a vulnerable octogenarian 
      cancer population. Its results are consistent with patient functional status 
      being a mediator of frailty and with both serving as intertwined markers of 
      clinical vulnerability. In addition, according to our results, cancer and 
      specific environmental stressors, such as surgery, are likely to affect the 
      frailty trajectory.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Giannotti, Chiara
AU  - Giannotti C
AD  - Geriatrics Clinic, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San 
      Martino, 16132 Genoa, Italy.
FAU - Sambuceti, Silvia
AU  - Sambuceti S
AD  - Geriatrics Clinic, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San 
      Martino, 16132 Genoa, Italy.
FAU - Signori, Alessio
AU  - Signori A
AD  - Department of Health Science (DISSAL), University of Genoa, 16132 Genoa, Italy.
FAU - Ballestrero, Alberto
AU  - Ballestrero A
AD  - Geriatrics Clinic, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San 
      Martino, 16132 Genoa, Italy.
FAU - Murialdo, Roberto
AU  - Murialdo R
AD  - IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
FAU - Romairone, Emanuele
AU  - Romairone E
AD  - Oncological Surgery and Implantable Systems, Hospital Policlinic San Martino, 
      Genoa, Italy.
FAU - Scabini, Stefano
AU  - Scabini S
AD  - Oncological Surgery and Implantable Systems, Hospital Policlinic San Martino, 
      Genoa, Italy.
FAU - Caffa, Irene
AU  - Caffa I
AD  - Geriatrics Clinic, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genoa, 16132 Genoa, Italy.
FAU - Odetti, Patrizio
AU  - Odetti P
AD  - Geriatrics Clinic, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San 
      Martino, 16132 Genoa, Italy.
FAU - Nencioni, Alessio
AU  - Nencioni A
AD  - Geriatrics Clinic, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San 
      Martino, 16132 Genoa, Italy. Electronic address: alessio.nencioni@unige.it.
FAU - Monacelli, Fiammetta
AU  - Monacelli F
AD  - Geriatrics Clinic, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genoa, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San 
      Martino, 16132 Genoa, Italy. Electronic address: fiammetta.monacelli@unige.it.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190507
PL  - Netherlands
TA  - J Geriatr Oncol
JT  - Journal of geriatric oncology
JID - 101534770
SB  - IM
MH  - *Activities of Daily Living
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/epidemiology/pathology/*surgery
MH  - Comorbidity
MH  - *Digestive System Surgical Procedures
MH  - Elective Surgical Procedures
MH  - Female
MH  - Frailty/*diagnosis/epidemiology/physiopathology/therapy
MH  - Geriatric Assessment
MH  - Humans
MH  - Male
MH  - Mass Screening
MH  - Mood Disorders/therapy
MH  - *Mortality
MH  - Multivariate Analysis
MH  - Neoplasm Staging
MH  - Nutritional Support
MH  - Pain Management
MH  - Postoperative Complications/*epidemiology
MH  - Stomach Neoplasms/epidemiology/pathology/*surgery
OTO - NOTNLM
OT  - Cancer
OT  - Frailty assessment
OT  - Long-term mortality and functional decline
OT  - Older adults
OT  - Surgery
EDAT- 2019/05/12 06:00
MHDA- 2020/08/18 06:00
CRDT- 2019/05/12 06:00
PHST- 2018/08/31 00:00 [received]
PHST- 2019/04/03 00:00 [revised]
PHST- 2019/04/21 00:00 [accepted]
PHST- 2019/05/12 06:00 [pubmed]
PHST- 2020/08/18 06:00 [medline]
PHST- 2019/05/12 06:00 [entrez]
AID - S1879-4068(18)30344-8 [pii]
AID - 10.1016/j.jgo.2019.04.017 [doi]
PST - ppublish
SO  - J Geriatr Oncol. 2019 Sep;10(5):716-723. doi: 10.1016/j.jgo.2019.04.017. Epub 
      2019 May 7.