ArticleFrontiers in immunology2023
Effects of systemic inflammation and frailty on survival in elderly cancer patients: Results from the INSCOC study.
Article in Frontiers in immunology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 24 citations in OpenAlex.
- Lack of Immune Resilience Negatively Affects Physical Resilience: Results From the InCHIANTI Follow-Up Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Trial
- Dynamic changes in frailty and related factors in older patients with liver cancer: A latent transition analysis approach.Asia-Pacific journal of oncology nursing · 2026Article
- The FINE Index: A Frailty- and Immunonutrition-Based Nomogram for Survival in Geriatric Breast Cancer: A Retrospective Study.Cancer medicine · 2026Article
- Multidimensional physiological impairments are associated with frailty and survival in older patients with cancer.Journal of translational internal medicine · 2026Article
- Nutrition impact symptoms and the risk of malnutrition, frailty, and sarcopenia in adults with cancer: A cross-sectional latent class analysis.JPEN. Journal of parenteral and enteral nutrition · 2026Article
- Interacting and joint effects of frailty and depressive symptoms in relation to risk of cardio-oncology comorbidity in older adults from three prospective cohorts.BMC geriatrics · 2026Article
- Age-specific patterns of lymph node involvement in elderly patients with oral squamous cell carcinoma: a retrospective cohort study.Clinical oral investigations · 2026Article
- Risk Stratification for Postoperative Mortality in Cardiac Surgery: "Quo Vadis"?Medicina (Kaunas, Lithuania) · 2026Review
- Tumor burden and frailty: No association in liver transplantation candidates with hepatocellular carcinoma.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- The 5-factor modified frailty index predicts local control and overall survival following spine stereotactic body radiation therapy.Journal of neuro-oncology · 2026Article
- High burden of geriatric assessment impairments across the adult age spectrum in patients with cancer.The oncologist · 2026Article
- Association of multimorbidity patterns and order of physical frailty and cognitive impairment occurrence: a prospective cohort study.Age and ageing · 2025Article
- L-shaped association of low-density lipoprotein cholesterol with all-cause and cardiovascular mortality in cancer survivors: a population-based cohort study.Frontiers in cardiovascular medicine · 2025Article
- Predictive Value of Inflammation Markers for Frailty in Older Patients with CVD.Clinical interventions in aging · 2025Article
- Associations between sarcopenia (defined by low muscle mass), inflammatory markers, and all-cause mortality in older adults: mediation analyses in a large U.S. NHANES community sample, 1999-2006.Frontiers in medicine · 2025Article
- Cancer disrupts sex hormone-inflammation relationships: Analysis of ALI in males from NHANES 2007-2018.PloS one · 2025Article
- Correlations between frailty index and inflammatory markers derived from blood cell count in the United States.BMC public health · 2024Article
- Adherence to the Mediterranean Diet Mitigates Inflammation and Hospital Stay in Frail Elderly Patients: A Moderation Analysis.Nutrients · 2024Article
- Frailty and Colorectal Surgery: Review and Concept of Cancer Frailty.Journal of clinical medicine · 2023Review
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Authors and funding
16 authors at 9 institutions in 1 country.
Funding
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Abstract
Background: Frailty and systemic inflammation are parameters, which are easy to evaluate, can be used to predict disease outcomes, and are potentially modifiable. The combination of frailty and inflammation-based data may help identify elderly cancer patients predisposed to adverse clinical outcomes. The aim of this study was to examine the association of systemic inflammation and frailty at admission, and to determine whether these risk factors interact and may predict the survival of elderly cancer patients. Methods: A prospective Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) with 5,106 elderly cancer patients admitted from 2013 through 2020 was included in this study. The primary marker of inflammation was the neutrophil-to-lymphocyte ratio (NLR), with the reference group having NLR<3, which indicated no inflammation. Frailty was assessed using the FRAIL scale, and patients with≥3 positives out of a total of five components were assumed to be frail. The primary outcome was all-cause mortality. We classified participants according to the presence (or absence) of frailty and high inflammation and assessed their association with overall survival using the Cox proportional hazards models adjusted for demographic, tumor, and treatment factors. Results: Among the 5,106 patients enrolled in the study, 3396 individuals (66.51%) were male and the mean( ± SD) age at diagnosis was 70.92( ± 5.34). Over a median of 33.5 months follow-up, we observed 2,315 deaths. Increasing NLR was associated with frailty (compared with NLR<3, odds ratio=1.23, 95%CI=1.08-1.41 for NLR≥3). An NLR≥3 and frailty independently predicted the overall survival [hazard ratio(HR)=1.35, 95%CI=1.24-1.47 and HR=1.38, 95%CI=1.25-1.52, respectively). Patients with both frailty and NLR≥3 had the lowest overall survival(HR=1.83, 95%CI=1.59-2.04) than patients with no risk factors. The mortality rate increased with the presence of the frailty components. Conclusions: Systemic inflammation was positively associated with frailty. Frail elderly cancer patients with elevated systemic inflammation had low survival rate.
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