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Frailty and long-term survival of patients with colorectal cancer: a meta-analysis

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Abstract

Background

Frailty has been related with the risk of postoperative complication in patients with colorectal cancer (CRC). However, the association between frailty and long-term survival in patients with CRC has not been comprehensively evaluated. We performed a meta-analysis to systematically evaluate the relationship between frailty and long-term survival of these patients.

Methods

Relevant cohort studies with follow-up duration ≥ 1 year were identified from Medline, Embase, and Web of Science. A random-effect model after incorporation of the between-study heterogeneity was selected to pool the results.

Results

Ten cohort studies with 35,546 patients were included, and 4100 (11.5%) of them had frailty. Pooled results showed that patients with frailty had worse overall survival compared to those without frailty at baseline (relative risk [RR]: 2.21, 95% confidence interval [CI] 1.43–3.41, P < 0.001; I2 = 92%). Results were consistent for studies adjusting age (RR: 2.20, P < 0.001) or including older cancer patients only (RR: 2.28, P = 0.002). Subgroup analyses showed that difference in study design, follow-up duration, or study quality scores may not significantly affect the findings (P for subgroup analyses all > 0.05). Further meta-analyses with two datasets showed that frailty was also associated with worse cancer-specific survival (RR: 4.60, 95% CI 2.75–7.67, P < 0.001; I2 = 38%) and recurrence-free survival (RR: 1.72, 95% CI 1.30–2.28, P < 0.001; I2 = 0%).

Conclusions

Frailty at admission is associated with worse survival of patients with colorectal cancer.

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Authors and Affiliations

  1. The Second Department of Oncology, Luohe Central Hospital, No. 54 Renmin East Road, Luohe, 462000, China

    Suhua Chen, Tianjiang Ma, Taowei Li, Duoping Liu, Lang Chen, Guoyao Zhang, Lei Zhang & Yali Fu

  2. Department of Spinal Surgery, Luohe Central Hospital, Luohe, 462000, China

    Wei Cui

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  1. Suhua Chen
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  2. Tianjiang Ma
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Contributions

SC, TM, and YF designed the study. TM and WC performed literature search, study quality evaluation, and data extraction. TL, DL, LC, GZ, and LZ performed statistical analysis. All authors interpreted the results. SC drafted the manuscript. All authors revised the manuscript and approved the submission.

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Correspondence to Suhua Chen.

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Chen, S., Ma, T., Cui, W. et al. Frailty and long-term survival of patients with colorectal cancer: a meta-analysis. Aging Clin Exp Res 34, 1485–1494 (2022). https://doi.org/10.1007/s40520-021-02072-x

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