Soma Osamu, Hatakeyama Shingo, Okamoto Teppei, Fujita Naoki, Matsumoto Teppei, Tobisawa Yuki, Yoneyama Tohru, Yamamoto Hayato, Yoneyama Takahiro, Hashimoto Yasuhiro, Koie Takuya, Nakaji Shigeyuki, Ohyama Chikara
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Oncotarget. 2018 Apr 3;9(25):17396-17405. doi: 10.18632/oncotarget.24712.
Optimal tools for evaluating frailty among urological cancer patients remain unclear. We aimed to develop a quantitative frailty assessment tool comparing healthy individuals and urological cancer patients, and investigate the clinical implication of quantitative frailty on prognosis in urological cancer patients.
Gait speed, hemoglobin, serum albumin, exhaustion, and depression were significantly worse in patients with all types of cancers than in pair-matched controls. Frailty discriminant score (FDS) showed clear separation between controls and urological cancer patients, and significant association with the Fried criteria. Overall survivals were significantly shorter in patients with a higher score (>2.30) than in those with a lower score among nonprostate cancer (bladder, upper tract urothelial carcinoma, and renal cell carcinoma) patients. In prostate cancer patients, overall survivals were significantly shorter in patients with a higher score (>3.30) than in those with a lower score.
FDS was significantly associated with frailty and prognosis in urological cancer patients. This tool for frailty assessment can help patients and physicians make more informed decisions. Further validation study is needed.
Total 605 urological cancer patients presenting to our hospital underwent a prospective frailty assessment. Controls were selected from 2280 community-dwelling subjects. Frailty was assessed via physical status, blood biochemical tests, and mental status. We compared frailty variables between pair-matched controls and urological cancer patients. We developed FDS using frailty variables, and compared with the Fried criteria. The influence of FDS on overall survivals was investigated by Kaplan-Meier analysis and Cox regression analysis.
评估泌尿生殖系统癌症患者虚弱程度的最佳工具仍不明确。我们旨在开发一种定量虚弱评估工具，用于比较健康个体和泌尿生殖系统癌症患者，并研究定量虚弱对泌尿生殖系统癌症患者预后的临床意义。
所有类型癌症患者的步速、血红蛋白、血清白蛋白、疲惫和抑郁状况均显著差于配对的对照组。虚弱判别评分（FDS）显示对照组和泌尿生殖系统癌症患者之间有明显区分，且与弗里德标准有显著关联。在非前列腺癌（膀胱癌、上尿路尿路上皮癌和肾细胞癌）患者中，评分较高（>2.30）的患者总生存期显著短于评分较低的患者。在前列腺癌患者中，评分较高（>3.30）的患者总生存期显著短于评分较低的患者。
FDS与泌尿生殖系统癌症患者的虚弱程度和预后显著相关。这种虚弱评估工具可帮助患者和医生做出更明智的决策。需要进一步的验证研究。
共有605例到我院就诊的泌尿生殖系统癌症患者接受了前瞻性虚弱评估。对照组从2280名社区居民中选取。通过身体状况、血液生化检查和精神状态评估虚弱程度。我们比较了配对对照组和泌尿生殖系统癌症患者之间的虚弱变量。我们使用虚弱变量开发了FDS，并与弗里德标准进行比较。通过Kaplan-Meier分析和Cox回归分析研究FDS对总生存期的影响。
