Top

Published in:

01-08-2019 | Sarcopenia | Urology - Review

Frailty as a prognostic indicator in the radical cystectomy population: a review

Authors: Niki Parikh, Pranav Sharma

Published in: International Urology and Nephrology | Issue 8/2019

Abstract

Radical cystectomy and urinary diversion are the current gold standard of management for patients with muscle-invasive bladder cancer. While it is a common urologic procedure, it is associated with significant patient morbidity and mortality. Complications associated with the operation are often frequent, although minor, and significantly impact functional outcomes as well as patient quality of life. Frailty is emerging as a new preoperative prognostic indicator to help determine which patients are at greatest risk of poor outcomes and postoperative complications after treatment. In this review, we summarize the current known literature analyzing frailty as a significant prognostic risk factor of short-term and long-term outcomes after radical cystectomy and urinary diversion in the treatment of muscle-invasive bladder cancer.

PDQ Cancer Information Summaries (2019) Bladder cancer treatment. National Cancer Institute, USA

Krishna SR, Konety BR (2017) Current concepts in the management of muscle invasive bladder cancer. Indian J Surg Oncol 8(1):74–81. https://doi.org/10.1007/s13193-016-0586-1 CrossRefPubMed

Nguyen TT, Huillard O, Dabi Y, Anract J, Sibony M, Zerbib M, Xylinas E (2018) Neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer and its impact on surgical morbidity and oncological outcomes: a real-world experience. Front Surg 5:58. https://doi.org/10.3389/fsurg.2018.00058 CrossRefPubMedPubMedCentral

Shabsigh A, Korets R, Vora KC, Brooks CM, Cronin AM, Savage C, Raj G, Bochner BH, Dalbagni G, Herr HW, Donat SM (2009) Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol 55(1):164–174. https://doi.org/10.1016/j.eururo.2008.07.031 CrossRefPubMed

Liedberg F (2010) Early complications and morbidity of radical cystectomy. Eur Urol Suppl 9(1):25–30CrossRef

Djaladat H, Katebian B, Bazargani ST, Miranda G, Cai J, Schuckman AK, Daneshmand S (2017) 90-day complication rate in patients undergoing radical cystectomy with enhanced recovery protocol: a prospective cohort study. World J Urol 35(6):907–911. https://doi.org/10.1007/s00345-016-1950-z CrossRefPubMed

LeBrasseur NK, Tchkonia T, Kirkland JL (2015) Cellular senescence and the biology of aging, disease, and frailty. Nestle Nutr Inst Workshop Ser 83:11–18. https://doi.org/10.1159/000382054 CrossRefPubMedPubMedCentral

Chen X, Mao G, Leng SX (2014) Frailty syndrome: an overview. Clin Interv Aging 9:433–441. https://doi.org/10.2147/cia.s45300 CrossRefPubMedPubMedCentral

Fedarko NS (2011) The biology of aging and frailty. Clin Geriatr Med 27(1):27–37. https://doi.org/10.1016/j.cger.2010.08.006 CrossRefPubMedPubMedCentral

10.

Zhang X, Meng X, Chen Y, Leng SX, Zhang H (2017) The biology of aging and cancer: frailty, inflammation, and immunity. Cancer J 23(4):201–205. https://doi.org/10.1097/ppo.0000000000000270 CrossRefPubMed

11.

Santilli V, Bernetti A, Mangone M, Paoloni M (2014) Clinical definition of sarcopenia. Clin Cases Miner Bone Metab 11(3):177–180PubMedPubMedCentral

12.

Mayr R, Fritsche HM, Zeman F, Reiffen M, Siebertz L, Niessen C, Pycha A, van Rhijn BWG, Burger M, Gierth M (2018) Sarcopenia predicts 90-day mortality and postoperative complications after radical cystectomy for bladder cancer. World J Urol 36(8):1201–1207. https://doi.org/10.1007/s00345-018-2259-x CrossRefPubMed

13.

Psutka SP, Carrasco A, Schmit GD, Moynagh MR, Boorjian SA, Frank I, Stewart SB, Thapa P, Tarrell RF, Cheville JC, Tollefson MK (2014) Sarcopenia in patients with bladder cancer undergoing radical cystectomy: impact on cancer-specific and all-cause mortality. Cancer 120(18):2910–2918. https://doi.org/10.1002/cncr.28798 CrossRefPubMed

14.

Mayr R, Gierth M, Zeman F, Reiffen M, Seeger P, Wezel F, Pycha A, Comploj E, Bonatti M, Ritter M, van Rhijn BWG, Burger M, Bolenz C, Fritsche HM, Martini T (2018) Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer. J Cachexia Sarcopenia Muscle 9(3):505–513. https://doi.org/10.1002/jcsm.12279 CrossRefPubMedPubMedCentral

15.

Okita K, Hatakeyama S, Fujita N, Konishi S, Yamamoto H, Imai A, Yoneyama T, Hashimoto Y, Ito H, Yoshikawa K, Koie T, Ohyama C (2018) Postoperative weight loss followed by radical cystectomy predicts poor prognosis in patients with muscle-invasive bladder cancer. Med Oncol 36(1):7. https://doi.org/10.1007/s12032-018-1232-2 CrossRefPubMed

16.

Subramaniam S, Aalberg JJ, Soriano RP, Divino CM (2018) New 5-factor modified frailty index using american college of surgeons nsqip data. J Am Coll Surg 226(2):173. https://doi.org/10.1016/j.jamcollsurg.2017.11.005 CrossRefPubMed

17.

Pearl JA, Patil D, Filson CP, Arya S, Alemozaffar M, Master VA, Ogan K (2017) Patient frailty and discharge disposition following radical cystectomy. clin genitourin Cancer 15(4):e615–e621. https://doi.org/10.1016/j.clgc.2016.12.013 CrossRefPubMed

18.

Suskind AM, Jin C, Cooperberg MR, Finlayson E, Boscardin WJ, Sen S, Walter LC (2016) Preoperative frailty is associated with discharge to skilled or assisted living facilities after urologic procedures of varying complexity. Urology 97:25–32. https://doi.org/10.1016/j.urology.2016.03.073 CrossRefPubMed

19.

Chappidi MR, Kates M, Patel HD, Tosoian JJ, Kaye DR, Sopko NA, Lascano D, Liu JJ, McKiernan J, Bivalacqua TJ (2016) Frailty as a marker of adverse outcomes in patients with bladder cancer undergoing radical cystectomy. Urol Oncol 34(6):256.e251–256.e256. https://doi.org/10.1016/j.urolonc.2015.12.010 CrossRef

20.

Taylor BL, Xia L, Guzzo TJ, Scherr DS, Hu JC (2019) Frailty and greater health care resource utilization following major urologic oncology surgery. Eur Urol Oncol 2(1):21–27. https://doi.org/10.1016/j.euo.2018.06.005 CrossRefPubMed

21.

Chang CM, Yin WY, Wei CK, Wu CC, Su YC, Yu CH, Lee CC (2016) Adjusted age-adjusted charlson comorbidity index score as a risk measure of perioperative mortality before cancer surgery. PLoS One 11(2):e0148076. https://doi.org/10.1371/journal.pone.0148076 CrossRefPubMedPubMedCentral

22.

Liu Y, Cohen ME, Hall BL, Ko CY, Bilimoria KY (2016) Evaluation and enhancement of calibration in the american college of surgeons nsqip surgical risk calculator. J Am Coll Surg 223(2):231–239. https://doi.org/10.1016/j.jamcollsurg.2016.03.040 CrossRefPubMed

23.

Owens WD, Felts JA, Spitznagel EL (1978) ASA physical status classifications: a study of consistency of ratings. Anesthesiology 49(4):239–243CrossRefPubMed

24.

Binder PS, Peipert JF, Kallogjeri D, Brooks RA, Massad LS, Mutch DG, Powell MA, Thaker PH, McCourt CK (2016) Adult comorbidity evaluation 27 score as a predictor of survival in endometrial cancer patients. Am J Obstet Gynecol 215(6):766.e761–766.e769. https://doi.org/10.1016/j.ajog.2016.07.035 CrossRef

25.

Atallah F, Letocart P, Malavaud B, Ahmad M, Mazerolles M, Minville V (2017) Can We Predict Morbidity and Mortality of Patients Aged 75 Years and Older Undergoing Cystectomy? J Frailty. Aging 6(2):72–75. https://doi.org/10.14283/jfa.2017.5 CrossRefPubMed

26.

Jeon K, Yoo H, Jeong BH, Park HY, Koh WJ, Suh GY, Guallar E (2017) Functional status and mortality prediction in community-acquired pneumonia. Respirology 22(7):1400–1406. https://doi.org/10.1111/resp.13072 CrossRefPubMed

27.

Lascano D, Pak JS, Kates M, Finkelstein JB, Silva M, Hagen E, RoyChoudhury A, Bivalacqua TJ, DeCastro GJ, Benson MC, McKiernan JM (2015) Validation of a frailty index in patients undergoing curative surgery for urologic malignancy and comparison with other risk stratification tools. Urol Oncol 33(10):426.e421. https://doi.org/10.1016/j.urolonc.2015.06.002 CrossRef

28.

Sathianathen NJ, Jarosek S, Lawrentschuk N, Bolton D, Konety BR (2018) A Simplified Frailty Index to Predict Outcomes After Radical Cystectomy. Eur Urol Focus. https://doi.org/10.1016/j.euf.2017.12.011 CrossRefPubMed

29.

Woldu SL, Sanli O, Clinton TN, Lotan Y (2019) Validating the predictors of outcomes after radical cystectomy for bladder cancer. Cancer 125(2):223–231. https://doi.org/10.1002/cncr.31799 CrossRefPubMed

30.

Meng X, Press B, Renson A, Wysock JS, Taneja SS, Huang WC, Bjurlin MA (2018) Discriminative ability of commonly used indexes to predict adverse outcomes after radical cystectomy: comparison of demographic data, american society of anesthesiologists, modified charlson comorbidity index, and modified frailty index. Clin Genitourin Cancer 16(4):e843–e850. https://doi.org/10.1016/j.clgc.2018.02.009 CrossRefPubMed

31.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Group CHSCR (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146–M156CrossRefPubMed

32.

Burg ML, Clifford TG, Bazargani ST, Lin-Brande M, Miranda G, Cai J, Schuckman AK, Djaladat H, Daneshmand S (2019) Frailty as a predictor of complications after radical cystectomy: A prospective study of various preoperative assessments. Urol Oncol 37(1):40–47. https://doi.org/10.1016/j.urolonc.2018.10.002 CrossRefPubMed

33.

Shariat SF, Milowsky M, Droller MJ (2009) Bladder cancer in the elderly. Urol Oncol 27(6):653–667. https://doi.org/10.1016/j.urolonc.2009.07.020 CrossRefPubMedPubMedCentral

34.

Choi Y, Oh DY, Kim TY, Lee KH, Han SW, Im SA, Bang YJ (2015) Skeletal Muscle depletion predicts the prognosis of patients with advanced pancreatic cancer undergoing palliative chemotherapy, independent of body mass index. PLoS One 10(10):e0139749. https://doi.org/10.1371/journal.pone.0139749 CrossRefPubMedPubMedCentral

35.

Carli F, Awasthi R, Gillis C, Kassouf W (2014) Optimizing a frail elderly patient for radical cystectomy with a prehabilitation program. Can Urol Assoc J 8(11–12):E884–E887. https://doi.org/10.5489/cuaj.2025 CrossRefPubMedPubMedCentral

Title: Frailty as a prognostic indicator in the radical cystectomy population: a review
Authors: Niki Parikh
Pranav Sharma
Publication date: 01-08-2019
Publisher: Springer Netherlands
Keywords: Sarcopenia
Cystectomy
Published in: International Urology and Nephrology / Issue 8/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-019-02189-z

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Frailty as a prognostic indicator in the radical cystectomy population: a review

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2019

Osmotic diuresis in chronic kidney disease: its significance and clinical utility

Intradetrusor injection of botulinum toxin A in children: a 10-year single centre experience

Clinical outcomes of stroke in hemodialysis patients: a retrospective single-center study

Response to the letter to editor: 24-h urine osmolality should be used in combination with other urine parameters in urolithiasis patients

Bone metabolism markers and hungry bone syndrome after parathyroidectomy in dialysis patients with secondary hyperparathyroidism

Assessment of men’s risk thresholds to proceed with prostate biopsy for the early detection of prostate cancer

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page