The modified 5-item frailty index predicts long-term mortality after breast cancer surgery in elderly women: A five-year follow-up study

IF 2.1 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2026-04-01 Epub Date: 2026-02-12 DOI:10.1016/j.suronc.2026.102369

Daniel Otero-Romero , Dolores Arribas-del-Amo

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引用次数: 0

Abstract

Purpose

Frailty is a major determinant of outcomes in older adults with cancer, and its identification in surgical oncology patients provides an opportunity to enhance perioperative care. However, the association of frailty with long-term outcomes remains poorly characterized. This study evaluated the prognostic value of the modified 5-item frailty index (mFI-5) in predicting long-term survival among elderly women undergoing breast cancer surgery.

Methods

A retrospective observational study was conducted including 290 women aged ≥70 years who underwent breast cancer surgery between 2016 and 2021. Frailty was assessed using the mFI-5 and categorized as fit (score = 0), pre-frail (score = 1), and frail (score ≥2). Long-term survival rates were analyzed across age groups, tumor subtypes, and TNM stages, stratified by mFI-5 category.

Results

Frailty was identified in 37.2% of patients and was strongly associated with reduced long-term overall survival (52.6% in frail vs. 88.4% in fit patients at 5 years). Multivariable Cox regression confirmed frailty as an independent predictor of mortality (HR 3.14, p = 0.003), primarily driven by non-cancer related deaths. The prognostic performance of the mFI-5 was consistent across all subgroups analyzed.

Conclusion

The mFI-5 is a simple and practical tool that identifies elderly women with breast cancer at increased risk of long-term mortality following surgery. Incorporating the mFI-5 into routine preoperative evaluation may facilitate improved treatment planning and outcomes.

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修改后的5项衰弱指数预测老年妇女乳腺癌手术后的长期死亡率：一项为期五年的随访研究

目的衰弱是老年癌症患者预后的主要决定因素，肿瘤外科患者衰弱的识别为加强围手术期护理提供了机会。然而，虚弱与长期预后的关系仍不明确。本研究评估改良的5项衰弱指数（mFI-5）在预测接受乳腺癌手术的老年妇女长期生存中的预后价值。方法回顾性观察研究纳入290例2016 - 2021年间接受乳腺癌手术的年龄≥70岁的女性。使用mFI-5评估虚弱程度，并将其分为适合（评分= 0）、预虚弱（评分= 1）和虚弱（评分≥2）。根据mFI-5分类，分析不同年龄组、肿瘤亚型和TNM分期的长期生存率。结果：37.2%的患者体弱多病，并与长期总生存率降低密切相关（5年时体弱多病患者为52.6%，健康患者为88.4%）。多变量Cox回归证实虚弱是死亡率的独立预测因子（HR 3.14, p = 0.003），主要由非癌症相关死亡驱动。mFI-5的预后表现在分析的所有亚组中是一致的。结论mFI-5是一种简单实用的工具，可用于识别老年乳腺癌术后长期死亡风险增加的妇女。将mFI-5纳入常规术前评估可能有助于改善治疗计划和结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.