Dataset Information

Impact of frailty on the management of patients with gynecological cancer aged 80 years and older.

ABSTRACT:

Purpose

To assess the impact of frailty on compliance of standard therapy, complication, rate and survival in patients with gynecological malignancy aged 80 years and older.

Methods

In total, 83 women with gynecological malignancy (vulva, endometrial, ovarian or cervical cancer) who underwent primary treatment between 2007 and 2017 were retrospectively analyzed. Frailty index was calculated and its association with compliance of standard treatment, peri- and postoperative mortality and morbidity, and survival was evaluated.

Results

Frailty was observed in 24.1% of cases. Both frail and non-frail patients were able to receive standard therapy in most cases - 75.0% and 85.7%, respectively (p?=?0.27). Frail patients did not show an increased postoperative complication rate. Frail patients had shorter 3 years overall survival rates (28%) when compared to non-frail patients (55%) (p?=?0.02). In multivariable analysis high frailty index (Hazard Ratio [HR] 12.15 [1.39-106.05], p?=?0.02) and advanced tumor stage (HR 1.33 [1.00-1.76], p?=?0.05) were associated with poor overall survival, but not age, histologic grading, performance status, and compliance of standard therapy.

Conclusion

Majority of patients was able to receive standard therapy, as suggested by the tumor board, irrespective of age and frailty. Nonetheless, frailty is a common finding in patients with gynecological malignancy aged 80 years and older. Frail patients show shorter progression-free, and overall survival within this cohort.

SUBMITTER: Reiser E

PROVIDER: S-EPMC7858206 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Impact of frailty on the management of patients with gynecological cancer aged 80 years and older.

Reiser Elisabeth E Pötsch Nina N Seebacher Veronika V Reinthaller Alexander A Wimazal Friedrich F Fleischmann Edith E Krainer Michael M Horvat Reinhart R Polterauer Stephan S Grimm Christoph C

Archives of gynecology and obstetrics 20201003 2

<h4>Purpose</h4>To assess the impact of frailty on compliance of standard therapy, complication, rate and survival in patients with gynecological malignancy aged 80 years and older.<h4>Methods</h4>In total, 83 women with gynecological malignancy (vulva, endometrial, ovarian or cervical cancer) who underwent primary treatment between 2007 and 2017 were retrospectively analyzed. Frailty index was calculated and its association with compliance of standard treatment, peri- and postoperative mortalit ...[more]

PMID: 33009994

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Project description:OBJECTIVES:Among kidney disease patients ≥80 years progressing to end-stage renal disease, there is growing interest in conservative nondialytic management approaches. However, among those who have initiated hemodialysis, little is known about the impact of withdrawal from dialysis on mortality, nor the patient characteristics associated with withdrawal from dialysis. STUDY DESIGN:Historical cohort study. SETTING AND PARTICIPANTS:We examined 133,162 incident hemodialysis patients receiving care within a large national dialysis organization from 2007 to 2011. MEASURES:We identified patients who withdrew from dialysis, either as a listed cause of death or censor reason. Incidence rates and subdistribution hazard ratios for withdrawal from dialysis as well as 4 other censoring reasons were examined across age groups. In addition, demographic and clinical characteristics associated with withdrawal from dialysis therapy among patients ≥80 years old was assessed using logistic regression analysis. RESULTS:Among 17,296 patients aged ≥80 years, 10% of patients withdrew from dialysis. Duration from the last hemodialysis treatment to death was 10 [interquartile range 6-16] days in patients with available data. Withdrawal from dialysis was the second and third most common cause of death among patients aged ≥80 years and <80 years, respectively. Among patients ≥80 years, minorities were much less likely than non-Hispanic whites to stop dialysis. Other factors associated with higher odds of dialysis withdrawal included having a central venous catheter compared to an arteriovenous fistula at dialysis start, dementia, living in mid-west regions, and less favorable markers associated with malnutrition-inflammation-cachexia syndrome such as higher white blood cell counts and lower body mass index, albumin, and normalized protein catabolic rate. CONCLUSION/IMPLICATIONS:Among very-elderly incident hemodialysis patients, dialysis therapy withdrawal exhibits wide variations across age, race and ethnicity, regions, cognitive status, dialysis vascular access, and nutritional status. Further studies examining implications of withdrawal from dialysis in older patients are warranted.

Dataset Information

Impact of frailty on the management of patients with gynecological cancer aged 80 years and older.

Purpose

Methods

Results

Conclusion

Publications

Impact of frailty on the management of patients with gynecological cancer aged 80 years and older.

Similar Datasets

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