Introduction/Background Frailty refers to the decrease in physiological reserve as well as multisystem impairments that develop separately to the normal ageing process. Objective frailty assessment can be valuable in the pre-operative risk-stratification of advanced ovarian cancer (OC) patients. We explored the association of Edmonton Frail Scale (EFS) on cytoreduction surgical outcomes.
Methodology We retrospectively collected data on consecutive patients who underwent cytoreductive surgery for OC between 2018–2022. This included demographics, morbidity, mortality and surgical outcomes including length of stay(LOS). We used inferential univariate statistics to describe our dataset. Spearman’s correlation was used to primarily explore the association between EFS and quoted pre-operative morbidity and mortality (P-POSSUM/SORT scales) as well as surgical outcomes including complications and LOS.
Results 161 patients with a median age of 68(IQR 60–75) underwent primary(N=95), interval(N=45) or delayed cytoreduction(N=21). The median ASA was 2(IQR 2–3) and the median operating time was 209minutes(IQR 142–279). Overall the preoperative median EFS was 3 out of 17(IQR 2–5), which translated into 126(78.3%)‘not frail’, 25(15.5%)‘vulnerable’, 8(5%)‘mildly frail’, 1(0.6%)‘moderately frail’ and 1(0.6%)‘severely frail’ patients. The median (IQR) HDU and overall length of stay was 2(1–4) and 7(5–10) days respectively. The median (IQR) number of post-operative complications was 0(0–2), with the median most severe complication being 2(1–3) on the Clavien-Dindo scale. Pre-operative EFS was statistically significantly associated with overall LOS (coef=0.164, p=0.038), total number of complications (coef=0.223, p=0.005), P-POSSUM morbidity score (coef=0.261, p=0.01), P-POSSUM mortality score (coef=0.288, p≤0.01), SORT score (coef=0.363, p≤0.01) and pre-operative serum albumin (coef= -0.176, p=0.025).
Conclusion EFS appears to correlate with quoted pre-operative morbidity and mortality (P-POSSUM/SORT) scales, as well as median length of stay and total number of complications. Hence EFS can be a useful adjunct in pre-operative counselling of patients undergoing cytoreductive surgery for ovarian cancer. This information can assist gynae-oncology teams in their treatment decisions and prehabilitation interventions.
Disclosures Nothing to disclose
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