Frailty and Intrinsic Capacity as Predictors of Recovery in Older Patients Surgically Treated for Cancer: A Longitudinal Study.

Background: Advanced age, cancer, and surgery contribute to functional decline, with concurrent cancer and surgery exacerbating this decline due to slower recovery and adverse outcomes.

Objective: To investigate the association between preoperative frailty and intrinsic capacity and postoperative functional recovery and quality of life in older patients surgically treated for cancer.

Methods: This longitudinal study at a tertiary care medical center included 74 patients 75 years and older undergoing elective surgery for malignancies, excluding those with terminal-stage cancer. Data on demographic variables, Cumulative Illness Rating Scale for Geriatrics, Clinical Frailty Scale, and intrinsic capacity were collected at admission. The Minimum Data Set Activities of Daily Living (MDS-ADL) and EuroQoL 5-dimension 3-level questionnaire (EQ5D) were assessed at admission, after operation, and 1 month, 3 months, 6 months, and 1 year after the operation for cancer.

Results: The mean age of the 74 participants was 80.3 ± 4.6 years, and 56.8% were female. The generalized estimating equation showed that an increased preoperative Clinical Frailty Scale score was significantly associated with worsened MDS-ADL (adjusted β = 1.25; 95% confidence interval = 0.39-2.11; P = .004) and decreased EQ5D score after surgery for cancer (adjusted β = -0.04; 95% confidence interval = -0.07 to -0.01; P = .004). No significant associations were observed between intrinsic capacity and postoperative MDS-ADL or EQ5D scores.

Conclusion: This study demonstrated that frailty is a better predictor of postoperative functional recovery and quality of life than intrinsic capacity in older cancer patients.

Implications for practice: Identifying frailty preoperatively can help healthcare providers better anticipate recovery challenges and tailor postsurgical care to improve outcomes.