The modified 5-item frailty index can be used to evaluate frailty using 5 routinely encountered clinical variables. This study aimed to assess the impact of the modified 5-item frailty index in patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma.
In this multicenter retrospective study, we calculated the modified 5-item frailty index scores of patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma between 2010 and 2022. Patients were categorized into the high (≥2) and low (≤1) modified 5-item frailty index score groups. To assess the prognostic influence of the preoperative modified 5-item frailty index, we conducted Cox proportional regression analyses concerning progression-free, overall, and cancer-specific survival.
Of 434 patients, 82, and 352 were classified into the high and low modified 5-item frailty index score groups, respectively. The high modified 5-item frailty index score group had significantly higher rates of severe surgical complications (P = .038) and ≥30 days of hospitalization (P = .049) and significantly worse progression-free (P = .012) and overall survival (P = .002) than the low modified 5-item frailty index score group. The multivariable Cox proportional hazard analysis revealed that a high modified 5-item frailty index score was independently associated with poor progression-free (P = .044), overall (P = .017), and cancer-specific survival (P = .005).
The modified 5-item frailty index emerged as a significant predictive indicator of severe surgical complications and postoperative survival outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy.
Clinical genitourinary cancer. 2023 Nov 30 [Epub ahead of print]
Yuki Kohada, Keisuke Goto, Ryo Tasaka, Kensuke Nishida, Kunihiro Hashimoto, Hideo Iwamoto, Tomoya Hatayama, Tomoki Furutani, Shunsuke Miyamoto, Kohei Kobatake, Hiroyuki Kitano, Kenichiro Ikeda, Akihiro Goriki, Keisuke Hieda, Tetsutaro Hayashi, Nobuyuki Hinata
Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan., Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. Electronic address: ., Department of Urology, Higashihiroshima Medical Center, Hiroshima, Japan., Department of Urology, JR Hiroshima Hospital, Hiroshima, Japan., Department of Urology, JA Onomichi General Hospital, Hiroshima, Japan., Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Department of Urology, Asa Citizens Hospital, Hiroshima, Japan., Department of Urology, Kure Medical Center Chugoku Cancer Center, Hiroshima, Japan.