Surgery in ovarian cancer patients older than 70 years of age and frailty assessment
Chronological age does not correlate precisely with physiological age, nor is age alone a predictor for the risk of poor recovery from surgery. Instead, it is necessary to determine patient frailty, defined as an ability to maintain homeostasis after stressors linked to the applied therapy, including extensive surgery. The clinical usefulness of the frailty assessment prior to surgery has been correlated with long-term outcomes in ovarian cancer patients and with the proposed modification of the Frailty Index as the Memorial Sloan Kettering-Frailty Index (MSK-FI) that includes both functional assessment and comorbidity. The aim of this study was the assessment of the frailty status of 114 patients based on the MSK-FI relative to the rates of 5-year overall survival in a group of older patients more than 70 years old treated surgically due to ovarian cancer. In our group of older patients operated on due to ovarian cancer, we have observed statistically significantly longer OS when the frailty status index as measured by the MSK-FI was less than 3. Notably, the patients from the high-risk group (MSK-FI ≥ 3) had statistically significant lower rates of complete resections. As the frailty status of the patient is a useful predictor of perioperative morbidity, it should be precisely determined prior to beginning treatment. The MSK-FI helps to support this process.