Preoperative risk factors for postoperative physical frailty in patients with esophageal cancer: a scoping review.

Esophageal cancer surgery is highly invasive and increases the risk of postoperative physical frailty. Identifying preoperative factors related to frailty is essential for early intervention in high-risk patients. In this scoping review, we aimed to identify and map existing evidence on preoperative predictors of postoperative physical frailty in patients with esophageal cancer. We searched MEDLINE, EMBASE, CENTRAL, and Web of Science. Eligible studies included cohort or case-control designs that assessed at least one preoperative factor and postoperative physical frailty, including several components, such as skeletal muscle mass, muscle strength, physical activity, or exercise capacity. Of 819 records, six cohort studies were included, all conducted in Japan, and most patients had esophageal squamous cell carcinoma. Among the included studies, three evaluated skeletal muscle mass, one evaluated sarcopenia, one evaluated physical activity, and one evaluated exercise capacity as postoperative outcomes. Reported preoperative risk factors were age, comorbidities, body mass index, neoadjuvant chemotherapy, vital capacity, step count, and the physical component of quality of life. Evidence on preoperative predictors of postoperative physical frailty in esophageal cancer is scarce and limited to Japanese cohorts. Nevertheless, age, comorbidities, exposure to neoadjuvant chemotherapy, and impaired preoperative patient-reported physical function may be used to identify high-risk patients. Further research is needed to validate these findings and to develop effective perioperative strategies for preventing postoperative physical frailty.