The Modified Frailty Index-5 as a Predictor of Postoperative Complications Following Radical Cystectomy

To evaluate the predictive value of the modified frailty index-5 (mFI-5) for postoperative complications in patients undergoing radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC).

A retrospective study. Place and Duration of the Study: Department of Urology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkiye, from January 2020 to July 2024.

A retrospective analysis was conducted on 184 individuals who underwent RC for muscle-invasive bladder cancer. Demographic data, medical history, histopathological results, perioperative parameters, complications, and mFI-5 score were recorded. Patients were categorised as having either high (mFI-5 scores ≥2) or low (mFI-5 scores <2) preoperative mFI-5 scores. The chi-square test was used to compare complications rate between the groups.

The study included 184 patients (91.3% male and 8.7% female), and the mean age was 65.23 ± 9.25 (24-86) years. Eighty-one (44%) out of 184 patients were in the high-risk group (mFI-5 ≥2), while 103 patients (56%) were in the low-risk group (mFI-5 <2). The rate of major complications (Clavien-Dindo ≥3) was found to be relatively higher in the high-risk group (n = 125, 30.86% vs. n = 18, 17.47%; p = 0.033). Although the overall complication rate did not differ between groups, gastrointestinal complications were found to be significantly higher (p = 0.005) in the high-risk group, with a longer duration of hospital stay.

A higher mFI-5 score is associated with a higher rate of major complications after radical cystectomy. The mFI-5 score may be a useful tool for determining treatment options in patients with MIBC.

Bladder cancer, Radical cystectomy, Modified frailty index-5, Complications, Outcome assessment.