Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Division of Rehabilitation, Kobe University Hospital, Kobe, Japan.
J Am Med Dir Assoc. 2021 Sep;22(9):1825-1830.e1. doi: 10.1016/j.jamda.2021.03.025. Epub 2021 Apr 28.
Frailty is a multidimensional syndrome. However, typical frailty scales used in oncology clinics assess physical impairment and/or malnutrition but do not consider the social domain. Our study aimed to clarify the relationship between preoperative social frailty and overall survival (OS) and cancer-specific survival (CSS) among older patients with gastrointestinal cancer.
This was a prospective cohort study.
This single-center study recruited 195 patients with gastrointestinal cancer scheduled for curative surgery and aged >60 years.
The outcomes considered were the OS and CSS of surgery. Primary associated factors included frailty defined as a Geriatric 8 score ≤14; social frailty defined as 2 or more of the following-going out less frequently, rarely visiting friends, feeling unhelpful to friends or family, living alone, and not talking with someone daily, and combinations therein [no frailty without social frailty (-/-), frailty without social frailty (+/-), no frailty with social frailty (-/+), and frailty with social frailty (+/+)]. We used the Cox proportional hazards model and the Fine and Gray proportional subdistribution hazard model adjusting for confounding factors.
Of the 195 patients, 181 (mean age, 72.0 years) were included for analysis. The median follow-up time was 994 days. Social frailty (hazard ratio 3.10) and their combinations [6.35; frailty with social frailty (+/+) vs no frailty without social frailty (-/-)] were significant predictors of OS. Social frailty (subdistribution hazard ratio 3.23) and their combinations (7.57) were significant predictors of CSS.
Preoperative social frailty is a predictor of OS and CSS in older patients with gastrointestinal cancer. Screening for social frailty, frailty, and their combinations in older patients with cancer is important.
衰弱是一种多维综合征。然而，肿瘤科常用的典型衰弱量表评估身体损伤和/或营养不良，但不考虑社会领域。我们的研究旨在阐明老年胃肠道癌症患者术前社会衰弱与总生存（OS）和癌症特异性生存（CSS）之间的关系。
这是一项前瞻性队列研究。
这项单中心研究招募了 195 名计划接受根治性手术的年龄>60 岁的胃肠道癌症患者。
考虑的结果是手术的 OS 和 CSS。主要相关因素包括定义为老年 8 分≤14 的衰弱；定义为以下 2 种或更多情况的社会衰弱：外出频率较低、很少拜访朋友、觉得对朋友或家人没有帮助、独居和每天不与他人交谈，以及其中的组合[无社会衰弱的无衰弱（-/-）、无衰弱的有社会衰弱（+/ -）、有社会衰弱的无衰弱（-/+）和有社会衰弱的有衰弱（+/+）]。我们使用 Cox 比例风险模型和 Fine 和 Gray 比例亚分布风险模型调整混杂因素。
在 195 名患者中，有 181 名（平均年龄 72.0 岁）被纳入分析。中位随访时间为 994 天。社会衰弱（风险比 3.10）及其组合[6.35；有社会衰弱的衰弱（+/+）与无社会衰弱的无衰弱（-/-）]是 OS 的显著预测因子。社会衰弱（亚分布风险比 3.23）及其组合（7.57）是 CSS 的显著预测因子。
术前社会衰弱是老年胃肠道癌症患者 OS 和 CSS 的预测因子。对老年癌症患者进行社会衰弱、衰弱及其组合的筛查很重要。
