Key result
Preoperative frailty predicts ~88% higher risk of 30-day postoperative complications in older colorectal cancer patients.
Why the study?
Reliable frailty assessment is urgently needed in oncology, prompting investigation into the validity of the Kihon Checklist for predicting postoperative complications in older colorectal cancer patients.
Does preoperative frailty assessment using the Kihon Checklist predict postoperative complications in older patients with colorectal cancer surgery?
Cohort (n=500)
Does preoperative frailty assessment using the Kihon Checklist predict postoperative complications in older patients with colorectal cancer surgery?
Hazard Ratio: 1.88 (95% CI 1.16–3.04)
p-value: p=0.011
The Kihon Checklist is a valid preoperative frailty assessment tool that independently predicts 30-day postoperative complications in older patients undergoing colorectal cancer surgery.
Supports preoperative frailty screening in older colorectal cancer patients; leaves open whether targeted interventions reduce complications.
OBJECTIVES: The increasingly elderly worldwide population has affected the incidence of colorectal cancer. Establishment of reliable assessment of frailty and proposals for multi-disciplinary interventions are urgently required in oncology practices. Kihon Checklist (KCL) was published by the Japanese Ministry of Health, Labor and Welfare originally to identify individuals ≥ 65 years old at probable risk for requiring care or social support. We investigate the validity of KCL for frailty assessment to predict postoperative complication in older patients with colorectal cancer. METHODS: Consecutive colorectal cancer patients aged ≥ 65 (n = 500) were prospectively examined between May 2017 and December 2018. Preoperative frailty assessment was conducted by the G8 questionnaire and KCL. The main outcome measures were correlation between frailty, other clinical variables, and postoperative complications within 30 days after elective surgery. RESULTS: Of the 500 patients, 278 (55.6%) and 164 (32.8%) patients were classified as 'frail' by G8 and KCL, respectively. Overall complications counted among 97 patients (19.4%), and they were significantly associated with KCL ≥ 8-frail (46/164, p = 0.001), as opposed to G8 ≤ 14-frail (56/278, p = 0.531). Multivariate analysis showed that KCL ≥ 8 (hazard ratio 1.88, 95% confidence interval 1.16-3.04, p = 0.011) was an independent risk factor for these complications. CONCLUSIONS: KCL assessment can identify frail older patients likely to suffer from postoperative complications after colorectal cancer surgery. Preoperative screening of frailty, particularly by KCL, would help older patients prevent their worse outcomes in colorectal cancer. TRIAL REGISTRATION: UMIN000026689.
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Tamura et al. (2021) conducted a cohort in colorectal cancer (n=500). Kihon Checklist (KCL) score ≥ 8 vs. KCL score < 8 was evaluated on postoperative complications within 30 days after elective surgery (HR 1.88, 95% CI 1.16-3.04, p=0.011). Preoperative frailty, defined as a Kihon Checklist score ≥ 8, independently predicted 30-day postoperative complications in older patients with colorectal cancer (HR 1.88; 95% CI 1.16-3.04; p=0.011).
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