Clinical Implication of a simple quantitative frailty assessment tool for prognosis in patients with urological cancers
To develop a simple and quantitative frailty assessment tool comparing healthy individuals, and investigate the clinical implication of quantitative frailty on prognosis in urological cancer patients.
Total 605 urological cancer patients presenting to our hospital underwent a prospective frailty assessment. Controls were selected from 2280 community-dwelling subjects. Frailty was assessed via physical status (handgrip strength and gait speed), blood biochemical tests (hemoglobin, albumin, and renal function), and mental status (exhaustion and depression). We compared frailty variables between pair-matched controls and urological cancer patients. We developed a frailty discriminant score (FDS), and the influence of FDS on overall survivals was investigated by Cox regression analysis.
Gait speed, hemoglobin, serum albumin, exhaustion, and depression were significantly worse in patients with all types of cancers than in pair-matched controls. FDS showed clear separation between controls and urological cancer patients. Overall survivals were significantly shorter in patients with a higher score (>2.30) than in those with a lower score among nonprostate cancer (bladder, upper tract urothelial carcinoma, and renal cell carcinoma) patients. In prostate cancer patients, overall survivals were significantly shorter in patients with a higher score (>3.30) than in those with a lower score.
FDS was significantly associated with frailty and prognosis in urological cancer patients. This tool for frailty assessment can help patients and physicians make more informed decisions. Further validation study is needed.