Modified 5-Item Frailty Index Score as Prognostic Marker After Radical Cystectomy in Bladder Cancer |
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| Affiliation: | 1. Department of Urology, Wakayama Medical University, Wakayama, Japan;2. Department of Urology, Kinan Hospital, Wakayama, Japan;3. Department of Urology, Rinku General Medical Center, Osaka, Japan;1. Urology Department, CHU, Brest, France;2. Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France;3. Radiology Department, CHU, Brest, France;4. Pathology Department, CHU, Brest, France;5. LaTIM, INSERM, UMR 1101, Université de Bretagne Occidentale, Brest, France;6. CeRePP, Paris, France;1. Department of Urology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;2. Guangdong Provincial Clinical Research Center for Urinary Diseases, Guangzhou, China;3. Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;4. Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;1. Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ;2. Division of Biometrics, Rutgers Cancer Institute of New Jersey and Rutgers School of Public Health, New Brunswick, NJ;3. Division of Medical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ;1. Penn State College of Medicine, Hershey, PA;2. Department of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA;3. Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA;1. Department of Medicine, McMaster University, Hamilton, Canada;2. Princess Margaret Cancer Centre, University Health Network, University of Toronto, Canada;3. Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada;4. Division of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, University of Toronto, Toronto, Canada;5. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada;6. Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada |
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| Abstract: | IntroductionA 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 MethodsIn 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.ResultsOf 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).ConclusionHigh preoperative modified 5-item frailty index score could be a significant independent predictor of poor prognosis after radical cystectomy in patients with bladder cancer. |
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