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
Irish Journal of Medical Science, cilt.194, sa.6, ss.2023-2029, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 194 Sayı: 6
- Basım Tarihi: 2025
- Doi Numarası: 10.1007/s11845-025-04108-x
- Dergi Adı: Irish Journal of Medical Science
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Sayfa Sayıları: ss.2023-2029
- Anahtar Kelimeler: Bladder cancer, Frailty, Prognosis, Radical cystectomy
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.