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PO010/#730  The impact of frailty on oncologic and survival outcomes in patients with gynecologic cancers: a population-based study
  1. Julie Mv Nguyen1,
  2. Tiffany Zigras2,
  3. Anastasia Gayowsky3,
  4. Andrew Costa4,
  5. Maura Marcucci5,
  6. Danielle Vicus2,
  7. Liat Hogen2 and
  8. Richard Perez4
  1. 1McMaster University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hamilton, Canada
  2. 2University of Toronto, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Toronto, Canada
  3. 3ICES McMaster University, Hamilton, Canada
  4. 4McMaster University, Department of Health Research Methods, Evidence and Impact, Hamilton, Canada
  5. 5Humanitas University, Clinical Epidemiology and Research Centre (cerc), Department of Biomedical Sciences, Milan, Italy

Abstract

Introduction There is limited literature on the impact of frailty on oncologic outcomes. We sought to evaluate survival outcomes in a gynecologic oncology population.

Methods Using province-wide administrative data, patients undergoing a laparotomy for a gynecologic malignancy between 2009-2021 were identified. Frailty was defined using the preoperative frailty index(pFI) and the John Hopkins Adjusted Clinical Groups frailty indicator(ACG). Hazard ratios (HR) were calculated using multivariable cox regression models. Kaplan-Meier curves were used to describe 5-year survival.

Results Of 21,359 patients, 1,405(6.6%) and 1,144(5.4%) were frail using the pFI and ACG, respectively. On multivariable regression analysis adjusting for age, primary cancer, stage, and Charlson comorbidity score, frailty was associated with lower 5-year survival (pFI: HR 1.3, 95% CI 1.2-1.42, p<0.0001, ACG: HR 1.56, 95% CI 1.43-1.70, p<0.0001). By cancer type, frailty was associated with adverse 5-year survival for endometrial cancer (HR 1.60, 95% CI 1.39-1.88, p<0.0001, ACG: 1.77, 95% 1.55-2.03, p<0.0001), and ovarian/primary peritoneal/tubal cancer (pFI: HR 1.16, 95% CI 1.03-1.30, p=0.01, ACG: 1.38, 95% CI 1.21-1.56, p<0.0001), and but not for cervical cancer (pFI: HR 0.78, 95% CI 0.37-1.66, p=0.52, ACG: 1.74, 95% CI 0.94=3/24, p=0.08). Frailty(pFI) was not associated with a different interval to initiation of adjuvant chemotherapy for ovarian cancer (pFI: mean 6 weeks(standard deviation(SD) 4.3) vs 6.5 weeks(SD 4.8), p=0.08, ACG: mean 6.6 weeks(SD 4.9), vs 6.5 weeks(SD 4.7), p=0.71).

Conclusion/Implications Frailty was significantly associated with adverse long-term oncologic survival, particularly in those with endometrial and ovarian cancer. Future research on the management of frailty is warranted.

Abstract PO010/#730 Table 1

Multivariable analysis for overall survival, full cohort

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