ArticleGynecologic oncology2022
Frailty repels the knife: The impact of frailty index on surgical intervention and outcomes.
Article in Gynecologic oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Impact of pre-operative frailty on short-term outcomes of ovarian cancer: a systematic review and meta-analysis.Journal of ovarian research · 2026Pooled it
- Frailty and long-term survival of patients with ovarian cancer: A systematic review and meta-analysis.Frontiers in oncology · 2022Pooled it
- Understanding frailty and the role of patient-centered care for older adults with gynecologic cancer.Gynecologic oncology · 2025Review
- Predictive value of the Adult Comorbidity Evaluation 27 on adverse surgical outcomes and survival in elderly with advanced epithelial ovarian cancer undergoing cytoreductive surgery.European journal of medical research · 2024Article
- Heterogeneity and treatment landscape of ovarian carcinoma.Nature reviews. Clinical oncology · 2023Review
- Molecular and phenotypic characteristics influencing the degree of cytoreduction in high-grade serous ovarian carcinomas.Cancer medicine · 2023Article
- Influence of interdisciplinary frailty screening on perioperative complication rates in elderly ovarian cancer patients: results of a retrospective observational study.Archives of gynecology and obstetrics · 2023Observational
- Predictive value of 5-Factor modified frailty index in Oncologic and benign hysterectomies.Gynecologic oncology reports · 2022Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo assess the impact of frailty in patients with ovarian cancer on surgical procedures and outcomes.
methodsA retrospective review of patients with stage II-IV ovarian cancer from April 2013 to September 2017 was performed. Patients were triaged by laparoscopy to determine primary resectability. The adjusted modified frailty index score (amFI) was calculated and amFI ≥2 classified as high frailty. Clinical outcomes, progression free survival (PFS) and overall survival (OS) were estimated.
results592 patients met inclusion criteria; amFI of 0, 1 and ≥ 2 was noted in 57%, 29%, and 14%, respectively. Patients with high frailty were less likely to be offered laparoscopic assessment for primary surgery (49% v. 43% v. 28% for amFI = 0, 1, and ≥ 2, p = 0.004), and more likely to have a Fagotti score ≥ 8 (58%, 48%, and 34%, p = 0.04). Only 17% of the high frailty cohort had primary tumor reductive surgery compared to 26% and 34% in patients with amFI = 1 and amFI = 0 (p = 0.02). Furthermore, patients with higher amFI were less likely to undergo any tumor reductive surgery (85% v. 74% v. 59%, p < 0.001). Postoperative complications were more frequent in patients with higher amFI (44% v. 56% v. 64%, p = 0.01). Death within thirty days of treatment initiation was significantly higher in patients with high frailty (0.4% v. 2% v. 9%, p = 0.005). In multivariate analysis, high frailty was associated with worse PFS (p = 0.02) and OS (p < 0.05).
conclusionsPostoperative morbidity, PFS, and OS were worse in patients with high frailty scores. Quantification of frailty may be useful for clinical decision making in patients with newly diagnosed advanced ovarian cancer.
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