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#615 Two-step frailty assessment algorithm leading to a high rate of state of the art surgery in women with gynecological malignancies – results of an interim-analysis of a prospective cohort study
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  1. Katharina Anic,
  2. Valerie Catherine Linz,
  3. Mona Wanda Schmidt,
  4. Ina Shehaj,
  5. Maria Schröder,
  6. Philip Klecker,
  7. Dennis Jung,
  8. Slavomir Krajnak,
  9. Marcus Schmidt,
  10. Roxana Schwab,
  11. Annette Hasenburg and
  12. Marco Johannes Battista
  1. University Hospital Mainz, Mainz, Germany

Abstract

Introduction/Background The omission of state of the art (SOTA) surgery results in lower survival rates in the elderly. Here, we report an interim-analysis of a prospective observational cohort study on the impact of a praeoperative, multidisciplinary, two-step frailty assessment in gynecological malignancies.

Methodology Women were included meeting one of the following criteria 1) age 60 years and older, 2) BMI>30kg/m2 or 3) subjective frail impression. The screening step uses the G8-Score accompanied by the Lee-Index and various laboratory values. If the G8-Score was impaired, a complete geriatric assessment (CGA) was performed accompanied by the history of falls, MiniCoq, Barthel-Index and Geriatric Depression Scale. Here, we report an interim-analysis after a recruiting period of 33 months.

Results 133 women (median age 69.9 years) were included. 45 (33.6%) patients were affected by ovarian cancer, 40 (29.9%) by endometrial cancer, 28 (20.9%) by vulva cancer, 7 (5.2%) by cervical cancer and 13 (9.7%) by other malignancies. The first screening step identified 36 (27.1%) patients out of them 20 (15.0%) were regarded as frail by the CGA. 16 (12.0%) patients received an individualized operative strategy. Therefore, 117 patients (88.0%) underwent SOTA surgery. Impaired G8 score was associated with a higher rate of individualized operative surgery (24.2% vs. 8.5%), revision procedures (20.0% vs. 6.4%) and re-admission (20.0% vs. 4.0%) (all p-values <0.05). 21 (15.8%) recurrences and 11 (8.3%) deaths were recorded during the median follow-up time of 13.2 months.

Conclusion Our two-step frailty-assessment algorithm is feasible and identifies a substantial portion of patients who safely underwent SOTA surgery. Contrastingly, patients with an impaired G8 score were faced with an unfavorable perioperative outcome. Whether our two-step frailty-assessment algorithm stratifies patients in terms of prognosis will be addressed by this ongoing trial and should be answered with a larger number of events and an adequate follow-up time.

Disclosures The authors declare, that there do not exist any financial conflicts with the submitted abstract.

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