Frailty and restrictions in geriatric domains are associated with surgical complications but not with radiation-induced acute toxicity in head and neck cancer patients: A prospective study

Linda Bras; Julius de Vries; Suzanne Festen; Roel J H M Steenbakkers; Johannes A Langendijk; Max J H Witjes; Bernard F A M van der Laan; Geertruida H de Bock; Gyorgy B Halmos

doi:10.1016/j.oraloncology.2021.105329

Frailty and restrictions in geriatric domains are associated with surgical complications but not with radiation-induced acute toxicity in head and neck cancer patients: A prospective study

Linda Bras^*, Julius de Vries, Suzanne Festen, Roel J H M Steenbakkers, Johannes A Langendijk, Max J H Witjes, Bernard F A M van der Laan, Geertruida H de Bock, Gyorgy B Halmos

^*Corresponding author voor dit werk

Onderzoeksoutput › Academic › peer review

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OBJECTIVES: We aimed to evaluate the association between frailty screening and geriatric assessment (GA) on short term adverse events in patients treated for head and neck cancer (HNC) for the first time in a prospective study.

MATERIALS AND METHODS: Newly diagnosed HNC patients undergoing curative treatment were prospectively included in OncoLifeS, a data biobank. Prior to the start of treatment, frailty was assessed with a GA, Groningen Frailty Indicator (GFI) and Geriatric-8 (G8). The GA included comorbidity (Adult Comorbidity Evaluation - 27), nutritional status (Malnutrition Universal Screening Tool), functional status ((instrumental) Activities of Daily Living), mobility (Timed Up & Go), psychological (Geriatric Depression Scale 15) and cognitive (Mini Mental State Examination) measures. Clinically relevant postoperative complications (Clavien-Dindo ≥ grade 2) and acute radiation-induced toxicity (Common Terminology Criteria for Adverse Events version 4.0 ≥ grade 2) were defined as outcome measures. Univariable and multivariable logistic regression analyses were performed, yielding odds ratios (ORs) and 95% confidence intervals (95%CIs).

RESULTS: Of the 369 included patients, 259 patients were eligible for analysis. Postoperative complications occurred in 41/148 (27.7%) patients and acute radiation-induced toxicity was present in 86/160 (53.7%) patients. Number of deficit domains of GA (OR = 1.71, 95%CI = 1.14-2.56), GFI (OR = 2.54, 95%CI = 1.02-6.31) and G8 (OR5.59, 95%CI = 2.14-14.60) were associated with postoperative complications, but not with radiation-induced toxicity.

CONCLUSION: Frailty and restrictions in geriatric domains were associated with postoperative complications, but not with radiation-induced acute toxicity in curatively treated HNC patients. The results of this prospective study further emphasizes the importance of geriatric evaluation, particularly before surgery.

Originele taal-2	English
Artikelnummer	105329
Aantal pagina's	8
Tijdschrift	Oral Oncology
Volume	118
Vroegere onlinedatum	7-jun.-2021
DOI's	https://doi.org/10.1016/j.oraloncology.2021.105329
Status	Published - jul.-2021

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Bras, L., de Vries, J., Festen, S., Steenbakkers, R. J. H. M., Langendijk, J. A., Witjes, M. J. H., van der Laan, B. F. A. M., de Bock, G. H., & Halmos, G. B. (2021). Frailty and restrictions in geriatric domains are associated with surgical complications but not with radiation-induced acute toxicity in head and neck cancer patients: A prospective study. Oral Oncology, 118, Artikel 105329. https://doi.org/10.1016/j.oraloncology.2021.105329

@article{a8e3353b49cb4adeae7e814e75c00d41,

title = "Frailty and restrictions in geriatric domains are associated with surgical complications but not with radiation-induced acute toxicity in head and neck cancer patients: A prospective study",

abstract = "OBJECTIVES: We aimed to evaluate the association between frailty screening and geriatric assessment (GA) on short term adverse events in patients treated for head and neck cancer (HNC) for the first time in a prospective study.MATERIALS AND METHODS: Newly diagnosed HNC patients undergoing curative treatment were prospectively included in OncoLifeS, a data biobank. Prior to the start of treatment, frailty was assessed with a GA, Groningen Frailty Indicator (GFI) and Geriatric-8 (G8). The GA included comorbidity (Adult Comorbidity Evaluation - 27), nutritional status (Malnutrition Universal Screening Tool), functional status ((instrumental) Activities of Daily Living), mobility (Timed Up & Go), psychological (Geriatric Depression Scale 15) and cognitive (Mini Mental State Examination) measures. Clinically relevant postoperative complications (Clavien-Dindo ≥ grade 2) and acute radiation-induced toxicity (Common Terminology Criteria for Adverse Events version 4.0 ≥ grade 2) were defined as outcome measures. Univariable and multivariable logistic regression analyses were performed, yielding odds ratios (ORs) and 95% confidence intervals (95%CIs).RESULTS: Of the 369 included patients, 259 patients were eligible for analysis. Postoperative complications occurred in 41/148 (27.7%) patients and acute radiation-induced toxicity was present in 86/160 (53.7%) patients. Number of deficit domains of GA (OR = 1.71, 95%CI = 1.14-2.56), GFI (OR = 2.54, 95%CI = 1.02-6.31) and G8 (OR5.59, 95%CI = 2.14-14.60) were associated with postoperative complications, but not with radiation-induced toxicity.CONCLUSION: Frailty and restrictions in geriatric domains were associated with postoperative complications, but not with radiation-induced acute toxicity in curatively treated HNC patients. The results of this prospective study further emphasizes the importance of geriatric evaluation, particularly before surgery.",

keywords = "Head and Neck Neoplasms, Geriatric Assessment, Frailty, Postoperative Complications, Radiotherapy, Logistic Models, Prospective studies, OLDER PATIENTS, OUTCOMES, COMORBIDITY, VALIDATION, INDEX, AGE",

author = "Linda Bras and {de Vries}, Julius and Suzanne Festen and Steenbakkers, {Roel J H M} and Langendijk, {Johannes A} and Witjes, {Max J H} and {van der Laan}, {Bernard F A M} and {de Bock}, {Geertruida H} and Halmos, {Gyorgy B}",

year = "2021",

month = jul,

doi = "10.1016/j.oraloncology.2021.105329",

language = "English",

volume = "118",

journal = "Oral Oncology",

issn = "1368-8375",

publisher = "ELSEVIER SCIENCE BV",

}

Bras, L , de Vries, J , Festen, S , Steenbakkers, RJHM , Langendijk, JA , Witjes, MJH , van der Laan, BFAM , de Bock, GH & Halmos, GB 2021, 'Frailty and restrictions in geriatric domains are associated with surgical complications but not with radiation-induced acute toxicity in head and neck cancer patients: A prospective study', Oral Oncology, vol. 118, 105329. https://doi.org/10.1016/j.oraloncology.2021.105329

TY - JOUR

T1 - Frailty and restrictions in geriatric domains are associated with surgical complications but not with radiation-induced acute toxicity in head and neck cancer patients

T2 - A prospective study

AU - Bras, Linda

AU - de Vries, Julius

AU - Festen, Suzanne

AU - Steenbakkers, Roel J H M

AU - Langendijk, Johannes A

AU - Witjes, Max J H

AU - van der Laan, Bernard F A M

AU - de Bock, Geertruida H

AU - Halmos, Gyorgy B

PY - 2021/7

Y1 - 2021/7

N2 - OBJECTIVES: We aimed to evaluate the association between frailty screening and geriatric assessment (GA) on short term adverse events in patients treated for head and neck cancer (HNC) for the first time in a prospective study.MATERIALS AND METHODS: Newly diagnosed HNC patients undergoing curative treatment were prospectively included in OncoLifeS, a data biobank. Prior to the start of treatment, frailty was assessed with a GA, Groningen Frailty Indicator (GFI) and Geriatric-8 (G8). The GA included comorbidity (Adult Comorbidity Evaluation - 27), nutritional status (Malnutrition Universal Screening Tool), functional status ((instrumental) Activities of Daily Living), mobility (Timed Up & Go), psychological (Geriatric Depression Scale 15) and cognitive (Mini Mental State Examination) measures. Clinically relevant postoperative complications (Clavien-Dindo ≥ grade 2) and acute radiation-induced toxicity (Common Terminology Criteria for Adverse Events version 4.0 ≥ grade 2) were defined as outcome measures. Univariable and multivariable logistic regression analyses were performed, yielding odds ratios (ORs) and 95% confidence intervals (95%CIs).RESULTS: Of the 369 included patients, 259 patients were eligible for analysis. Postoperative complications occurred in 41/148 (27.7%) patients and acute radiation-induced toxicity was present in 86/160 (53.7%) patients. Number of deficit domains of GA (OR = 1.71, 95%CI = 1.14-2.56), GFI (OR = 2.54, 95%CI = 1.02-6.31) and G8 (OR5.59, 95%CI = 2.14-14.60) were associated with postoperative complications, but not with radiation-induced toxicity.CONCLUSION: Frailty and restrictions in geriatric domains were associated with postoperative complications, but not with radiation-induced acute toxicity in curatively treated HNC patients. The results of this prospective study further emphasizes the importance of geriatric evaluation, particularly before surgery.

AB - OBJECTIVES: We aimed to evaluate the association between frailty screening and geriatric assessment (GA) on short term adverse events in patients treated for head and neck cancer (HNC) for the first time in a prospective study.MATERIALS AND METHODS: Newly diagnosed HNC patients undergoing curative treatment were prospectively included in OncoLifeS, a data biobank. Prior to the start of treatment, frailty was assessed with a GA, Groningen Frailty Indicator (GFI) and Geriatric-8 (G8). The GA included comorbidity (Adult Comorbidity Evaluation - 27), nutritional status (Malnutrition Universal Screening Tool), functional status ((instrumental) Activities of Daily Living), mobility (Timed Up & Go), psychological (Geriatric Depression Scale 15) and cognitive (Mini Mental State Examination) measures. Clinically relevant postoperative complications (Clavien-Dindo ≥ grade 2) and acute radiation-induced toxicity (Common Terminology Criteria for Adverse Events version 4.0 ≥ grade 2) were defined as outcome measures. Univariable and multivariable logistic regression analyses were performed, yielding odds ratios (ORs) and 95% confidence intervals (95%CIs).RESULTS: Of the 369 included patients, 259 patients were eligible for analysis. Postoperative complications occurred in 41/148 (27.7%) patients and acute radiation-induced toxicity was present in 86/160 (53.7%) patients. Number of deficit domains of GA (OR = 1.71, 95%CI = 1.14-2.56), GFI (OR = 2.54, 95%CI = 1.02-6.31) and G8 (OR5.59, 95%CI = 2.14-14.60) were associated with postoperative complications, but not with radiation-induced toxicity.CONCLUSION: Frailty and restrictions in geriatric domains were associated with postoperative complications, but not with radiation-induced acute toxicity in curatively treated HNC patients. The results of this prospective study further emphasizes the importance of geriatric evaluation, particularly before surgery.

KW - Head and Neck Neoplasms

KW - Geriatric Assessment

KW - Frailty

KW - Postoperative Complications

KW - Radiotherapy

KW - Logistic Models

KW - Prospective studies

KW - OLDER PATIENTS

KW - OUTCOMES

KW - COMORBIDITY

KW - VALIDATION

KW - INDEX

KW - AGE

U2 - 10.1016/j.oraloncology.2021.105329

DO - 10.1016/j.oraloncology.2021.105329

M3 - Article

C2 - 34111770

SN - 1368-8375

VL - 118

JO - Oral Oncology

JF - Oral Oncology

M1 - 105329

ER -

Frailty and restrictions in geriatric domains are associated with surgical complications but not with radiation-induced acute toxicity in head and neck cancer patients: A prospective study

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