Key result
, sample sizes). 4.
Why the study?
Frailty syndrome affects a considerable proportion of elderly patients undergoing major surgeries, but its effect on clinical outcomes after esophagectomy for esophageal cancer required systematic assessment.
Does frailty syndrome increase the risk of mortality and postoperative complications in patients undergoing esophagectomy for esophageal cancer?
Meta-Analysis
Does frailty syndrome increase the risk of mortality and postoperative complications in patients undergoing esophagectomy for esophageal cancer?
Effect estimate: OR 4.03 (95% CI 2.20-7.38)
p-value: p=< 0.05
Frailty is associated with a four-fold increased odds of surgery-related mortality and higher risks of postoperative pneumonia and cardiac complications in patients undergoing esophagectomy.
Frailty screening should guide esophagectomy risk counseling; reinforces pooled cohort data and prioritizes mitigation trials.
Introduction: Frailty syndrome is an increasingly recognized condition that affects a considerable proportion of elderly patients, particularly those undergoing major surgeries. In this meta-analysis, we aimed to systematically review and pool data from cohort studies to assess the effect of frailty on the clinical outcomes of patients undergoing esophagectomy for esophageal cancer. Methods: Major online medical databases such as PubMed, Embase, Scopus, and Web of Science were searched to gather all studies on the clinical outcomes of patients with frailty syndrome who underwent esophagectomy due to esophageal cancer. The study included articles published up to March 2026. Finally, 15 articles matched the required criteria and were included in this meta-analysis. Results: The pooled odds ratio for surgery-related mortality in patients with frailty syndrome and esophageal cancer undergoing esophagectomy has been established at 4.03 (Lower Limit: 2.20; Upper Limit: 7.38; p-value < 0.05). The pooled odds ratio for surgery-related postoperative pneumonia in patients with frailty syndrome and esophageal cancer undergoing esophagectomy has been established at 1.86 (Lower Limit: 1.16; Upper Limit: 2.98; p-value < 0.05). The pooled odds ratio for surgery-related postoperative cardiac complications in patients with frailty syndrome and esophageal cancer undergoing esophagectomy has been established at 1.73 (Lower Limit: 1.54; Upper Limit: 1.94; p-value < 0.05). Conclusions: Frailty is a powerful predictor of mortality in patients undergoing esophagectomy, with frail individuals facing nearly four times higher odds of death. This underscores the urgent need to integrate frailty assessments into standard preoperative screening to enhance risk stratification and optimize perioperative decision-making. A multidisciplinary approach is essential to improving resilience, recovery, and long-term survival in frail esophageal cancer patients. Future large-scale prospective trials should focus on standardizing assessment tools and evaluating the lasting impact of tailored interventions to ultimately enhance patient outcomes.
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Kamińska et al. (2026) conducted a meta-analysis in Esophageal cancer. Frailty syndrome was evaluated on Surgery-related mortality (OR 4.03, 95% CI 2.20-7.38, p=< 0.05). Frailty syndrome in patients undergoing esophagectomy for esophageal cancer was associated with significantly higher odds of surgery-related mortality (OR 4.03; 95% CI 2.20-7.38; p<0.05).
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