Irish journal of medical science · 2025
Assessing the use of modified 5-item frailty index as a prognostic marker of long-term survival and perioperative outcomes after radical cystectomy for bladder cancer.
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Sungur Ubeyd, Kerim Özfiliz Nahide, Ekşi Mithat, Kargı Taner, Karadağ Serdar, Bitkin Alper
Аннотация
BACKGROUND AND AIM: This study investigated the relationship between preoperative Modified 5-item Frailty Score (mFI-5) and long-term survival as well as 30-day postoperative complications in patients who underwent radical cystectomy for bladder cancer.
METHODS: Patients who underwent radical cystectomy between 2012-2023 were analyzed and divided into two groups based on their mFI-5 scores: low-risk (≤ 1) and high-risk (≥ 2). Overall survival (OS), cancer-specific survival (CSS), and 30-day postoperative complications were compared between these groups. Additionally, Cox proportional hazards regression analysis was used to examine the impact of the mFI-5 score on OS and CSS.
RESULTS: Our study included 288 patients with an average age of 63.8 ± 9.1 years at the time of surgery. Patients with a low mFI-5 score comprised 77.4% (n = 223) of the cohort, while 22.6% (n = 65) had a high mFI-5 score. The majority of patients had advanced-stage disease (pT3-pT4 for 53.8% (n = 155)). Patients with a high mFI-5 score demonstrated significantly worse OS and CSS compared to those with a low mFI-5 score (p = 0.002 and p = 0.007, respectively). Although 30-day mortality rates were significantly higher in the high mFI-5 score group (p = 0.002), the difference in overall complication rates was not statistically significant (p = 0.120). In multivariate Cox proportional hazards analysis, the mFI-5 score was identified as an independent predictor for both OS and CSS (p = 0.001 and p = 0.003, respectively).
CONCLUSION: mFI-5 score can provide valuable prognostic information regarding survival after radical cystectomy in bladder cancer patients, based on preoperative findings. It is an independent predictor of long-term survival.
METHODS: Patients who underwent radical cystectomy between 2012-2023 were analyzed and divided into two groups based on their mFI-5 scores: low-risk (≤ 1) and high-risk (≥ 2). Overall survival (OS), cancer-specific survival (CSS), and 30-day postoperative complications were compared between these groups. Additionally, Cox proportional hazards regression analysis was used to examine the impact of the mFI-5 score on OS and CSS.
RESULTS: Our study included 288 patients with an average age of 63.8 ± 9.1 years at the time of surgery. Patients with a low mFI-5 score comprised 77.4% (n = 223) of the cohort, while 22.6% (n = 65) had a high mFI-5 score. The majority of patients had advanced-stage disease (pT3-pT4 for 53.8% (n = 155)). Patients with a high mFI-5 score demonstrated significantly worse OS and CSS compared to those with a low mFI-5 score (p = 0.002 and p = 0.007, respectively). Although 30-day mortality rates were significantly higher in the high mFI-5 score group (p = 0.002), the difference in overall complication rates was not statistically significant (p = 0.120). In multivariate Cox proportional hazards analysis, the mFI-5 score was identified as an independent predictor for both OS and CSS (p = 0.001 and p = 0.003, respectively).
CONCLUSION: mFI-5 score can provide valuable prognostic information regarding survival after radical cystectomy in bladder cancer patients, based on preoperative findings. It is an independent predictor of long-term survival.