PMID- 38202219
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240112
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 13
IP  - 1
DP  - 2023 Dec 29
TI  - Frailty and Increased Levels of Symptom Burden Can Predict the Presence of Each 
      Other in HNSCC Patients.
LID - 10.3390/jcm13010212 [doi]
LID - 212
AB  - Frailty is an important risk factor for adverse events (AEs), especially in 
      elderly patients. Therefore, assessing frailty before therapy is recommended. In 
      head and neck squamous cell carcinoma (HNSCC) patients, frailty is prognostic for 
      severe postoperative complications and declining quality of life (QoL) after 
      HNSCC treatment. Thus, assessment of frailty may help to identify individuals at 
      risk for AE caused by oncologic therapy. We investigated the relationship between 
      frailty and symptom burden to better understand their interaction and impact on 
      HNSCC patients. In this prospectively designed cross-sectional study, the 
      presence of frailty and symptom burden was assessed by using the Geriatric 8 (G8) 
      and Minimal Documentation System (MIDOS(2)) questionnaires. A total of 59 
      consecutively accrued patients with a first diagnosis of HNSCC before therapy 
      were evaluated. Patients were considered frail at a total G8 score </= 14. The 
      MIDOS(2) symptom burden score was considered pathological with a total score >/= 4 
      or any severe symptom (=3). Statistical correlations were analyzed using Spearman 
      and Pearson correlation. Receiver operator characteristic (ROC) curves were used 
      to analyze the potential of predicting frailty and MIDOS(2). p-values < 0.05 were 
      considered significant. A total of 41 patients (69.5%) were considered frail, and 
      27 patients (45.8%) had increased symptom burden. "Tiredness" was the most common 
      (overall rate 57.8%) and "Pain" was the most often stated "severe" symptom (5 
      patients, 8.5%). G8 and MIDOS(2) correlated significantly (rho = -0.487, p < 0.001; 
      r = -0.423, p < 0.001). Frailty can be predicted by MIDOS(2) symptom score (AUC = 
      0.808, 95% CI 0.698-0.917, p < 0.001). Vice versa, the G8 score can predict 
      pathological symptom burden according to MIDOS(2) (AUC = 0.750, 95% CI 
      0.622-0.878, p < 0.001). Conclusions: The strong link between frailty and 
      increased symptom burden assessed by G8 or MIDOS(2) indicates a coherence of both 
      risk factors in HNSCC patients. Considering at least one of both scores might 
      improve the identification of individuals at risk and achieve higher QoL and 
      reduced complication rates by decision making for appropriate therapy regimens.
FAU - Kunz, Viktor
AU  - Kunz V
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital 
      Leipzig, 04103 Leipzig, Germany.
FAU - Wichmann, Gunnar
AU  - Wichmann G
AUID- ORCID: 0000-0001-6191-2095
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital 
      Leipzig, 04103 Leipzig, Germany.
FAU - Wald, Theresa
AU  - Wald T
AUID- ORCID: 0000-0002-7602-1743
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital 
      Leipzig, 04103 Leipzig, Germany.
FAU - Dietz, Andreas
AU  - Dietz A
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital 
      Leipzig, 04103 Leipzig, Germany.
FAU - Wiegand, Susanne
AU  - Wiegand S
AUID- ORCID: 0000-0003-1183-9226
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital 
      Leipzig, 04103 Leipzig, Germany.
LA  - eng
PT  - Journal Article
DEP - 20231229
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC10779894
OTO - NOTNLM
OT  - Edmonton Symptom Assessment System (ESAS)
OT  - Minimal Documentation System (MIDOS2)
OT  - frailty
OT  - geriatric questionnaire G8
OT  - head and neck cancer
OT  - head and neck squamous cell carcinoma (HNSCC)
OT  - symptom burden
COIS- The authors declare no conflict of interest.
EDAT- 2024/01/11 07:42
MHDA- 2024/01/11 07:43
PMCR- 2023/12/29
CRDT- 2024/01/11 01:10
PHST- 2023/12/01 00:00 [received]
PHST- 2023/12/22 00:00 [revised]
PHST- 2023/12/26 00:00 [accepted]
PHST- 2024/01/11 07:43 [medline]
PHST- 2024/01/11 07:42 [pubmed]
PHST- 2024/01/11 01:10 [entrez]
PHST- 2023/12/29 00:00 [pmc-release]
AID - jcm13010212 [pii]
AID - jcm-13-00212 [pii]
AID - 10.3390/jcm13010212 [doi]
PST - epublish
SO  - J Clin Med. 2023 Dec 29;13(1):212. doi: 10.3390/jcm13010212.