Introduction/Background Frailty is an underdiagnosed multidimensional age-related syndrome. Frail patients need to be identified preoperatively to reduce their risk of adverse surgical outcomes. We present first results of our systematic, preoperative two-step frailty screening algorithm of elderly ovarian cancer (OC) patients regarding their perioperative outcomes.
Methodology All women with the diagnosis of OC regardless of the previous treatments or the histological type were screened preoperatively by the G8 geriatric screening tool (G8-Score). If a patient was considered to be G8-frail (cut-off:≤14points), various geriatric assessment tools followed. The main outcome measures were the relationship between perioperative laboratory results, intraoperative surgical parameters and the incidence of immediate postoperative in-hospital complications with the preoperatively evaluated frailty status.
Results Till now, 37 consecutive patients with OC standardly treated with laparotomy for tumor debulking/extirpation at the University Medical Center Mainz between May 2020 and April 2023 were included. Mean age in the study cohort was 69.0 (±7.5) years. Most of the patients (72.9%) had advanced stage ovarian cancer ≥FIGOIIB. 35.1% of the patients were preoperatively identified as G8-frail (n=13). The G8-frail cohort had a significant longer hospital stay (p=0.005) and displayed a higher prevalence of polypharmacy than the G8-non-frail cohort (p=0.067). The G8-frail cohort showed a numerically but not statistically significant higher Clavien-Dindo-Score than the G8-non-frail cohort (grade≤2: 53.9% vs. 79.1%; grade≥3: 46.2% vs. 20.8%; p=0.402). Furthermore, the G8-frail cohort had significant more surgical revisions and readmitted more often to the hospital than the G8-non-frail cohort (revisions: 30.8% vs. 4%, p=0.042; readmission: 23.1% vs. 4%, p=0.115). One patient in each cohort died during the hospital stay.
Conclusion The first interim-analysis shows that preoperative frailty assessment with the G8-Score can prospectively identify elderly women with OC associated with polypharmacy, a higher rate of postoperative in-hospital and a longer hospital stay. Further results will be expected in the near future.
Disclosures The authors reports no potential conflict of interest.
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