{"id":21925,"date":"2025-06-07T16:54:52","date_gmt":"2025-06-07T20:54:52","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21925"},"modified":"2025-06-10T16:58:46","modified_gmt":"2025-06-10T20:58:46","slug":"association-of-frailty-with-perioperative-and-survival-outcomes-in-patients-with-gynecologic-cancers","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-of-frailty-with-perioperative-and-survival-outcomes-in-patients-with-gynecologic-cancers\/","title":{"rendered":"Association of frailty with perioperative and survival outcomes in patients with gynecologic cancers: a population-based study"},"content":{"rendered":"<p><strong>Objectives<\/strong> \u2014 The relationship between frailty and both short- and long-term outcomes remains underexplored in gynecologic oncology (GO). We sought to evaluate the association of frailty with 30-day complications, costs and mortality, and long-term survival following surgery.<\/p>\n<p><strong>Methods<\/strong> \u2014 A population-based observational retrospective cohort study of patients undergoing a laparotomy for a gynecologic malignancy between 2009 and 2021 was conducted using Ontario province-wide databases. Frailty was defined using the preoperative frailty index (pFI) and the John Hopkins Adjusted Clinical Groups frailty indicator (ACG).<\/p>\n<p><strong>Results<\/strong> \u2014 Among 21,359 patients, 1405 (6.6 %) and 1144 (5.4 %) were frail using the pFI and ACG.<br \/>\nFrailty as assessed by the pFI was associated with an increased risk of 30-daycomplications (25.7 % vs 7.4 %, p &lt; 0.0001), 30-day mortality (2.9 % vs 0.5 %, p &lt; 0.0001), 90-day mortality (7.1 % vs 1.4 %, p &lt; 0.0001), 30-day mean healthcare costs ($16,478 vs $9306, p &lt; 0.0001), and lower median 5 year-survival (3.28 years versus not reached).<\/p>\n<p>Frailty was independently associated with 30-day complications (OR 1.92, 95 % CI 1.63\u20132.27, p &lt; 0.0001)) in multivariable regression analysis adjusting for age, income quintile, primary cancer, stage, type of surgery and neoadjuvant chemotherapy, and with lower 5-year survival (HR 1.27, 95 % CI 1.16\u20131.38, p &lt; 0.0001) adjusting for age, primary cancer, stage, neoadjuvant chemotherapy and comorbidities.<br \/>\nResults for these outcomes were similar using the ACG. The ROC analysis revealed similar area under the curve for both indices.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Frailty as measured by both the pFI and ACG was predictive of outcomes including increased postoperative morbidity and mortality, and 5-year survival. Strategies to optimize perioperative care for frailty are required.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives \u2014 The relationship between frailty and both short- and long-term outcomes remains underexplored in gynecologic oncology (GO). We sought to evaluate the association of frailty with 30-day complications, costs and mortality, and long-term survival following surgery. Methods \u2014 A population-based observational retrospective cohort study of patients undergoing a laparotomy for a gynecologic malignancy between [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[38,25],"migration-helper-qa-sample-set":[],"class_list":["post-21925","journal_article","type-journal_article","status-publish","hentry","topic-cancer-and-cancer-screening","topic-surgery"],"acf":{"citation":"Nguyen JMV, Zigras T, Gayowsky A, Marcucci M, Vicus D, Nica A, Hogen L, Costa A, Perez R. <em>Gynecol Oncol<\/em>. 2025; 198:137-145. Epub 2025 Jun 7.","source_url":"https:\/\/doi.org\/10.1016\/j.ygyno.2025.05.021","ices_scientist":[1186,16709,22803],"site":[6737],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association of frailty with perioperative and survival outcomes in patients with gynecologic cancers: a population-based study<\/title>\n<meta name=\"description\" content=\"Objectives \u2014 The relationship between frailty and both short- and long-term outcomes remains underexplored in gynecologic oncology (GO). 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