Association Between Frailty and Time Alive and At Home After Cancer Surgery Among Older Adults: A Population-Based...

Area of Science:

• Geriatric Surgery
• Oncology
• Public Health

Background:

• Frailty's impact on short-term surgical outcomes is established.
• Long-term effects of frailty after cancer surgery remain understudied.

Purpose of the Study:

• To investigate the association between preoperative frailty and long-term survival and home status post-cancer surgery in older adults.
• To determine if frailty influences outcomes beyond the immediate postoperative period.

Main Methods:

• Population-based retrospective cohort study of adults aged ≥70 years undergoing cancer resection in Ontario, Canada.
• Linked administrative datasets were utilized.
• Kaplan-Meier methods and extended Cox regression with time-varying effects analyzed survival and home status over 5 years.

Main Results:

• 7.9% of 82,037 patients had preoperative frailty.
• Frail patients had significantly lower 5-year probability of remaining alive and at home (39.1% vs. 62.5%).
• Frailty independently predicted increased hazards of not remaining alive and at home, with elevated risk persisting beyond 1 year post-surgery.

Conclusions:

• Preoperative frailty is independently linked to poorer long-term outcomes (survival and home status) after cancer surgery in older adults.
• The detrimental effect of frailty persists across all cancer types and extends beyond the initial postoperative phase.
• Routine frailty assessment is recommended for all cancer surgery candidates to aid in counseling, selection, and preparation.