Effect of Preoperative Frailty on Prognosis of Pancreatic Cancer Patients after Pancreaticoduodenectomy
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2025.0316
- VernacularTitle:术前衰弱对胰腺癌患者胰十二指肠切除术后预后的影响
- Author:
Hui CHEN
1
;
Guifen FAN
2
;
Dongni XU
2
;
Yanan LU
2
Author Information
1. Department of Emergency， Sun Yat-sen Memorial Hospital， Sun Yat-sen University Guangzhou 510120， China
2. Department of Anesthesiology， Sun Yat-sen Memorial Hospital， Sun Yat-sen University， Guangzhou 510120， China
- Publication Type:Journal Article
- Keywords:
frailty;
the FRAIL questionnaire;
pancreatic cancer;
pancreaticoduodenectomy;
prognosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(3):512-518
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the impact of preoperative frailty on the prognosis of patients with pancreatic cancer who underwent pancreaticoduodenectomy. MethodsA retrospective analysis was conducted on the clinical data of 435 pancreatic cancer patients who underwent pancreaticoduodenectomy at Sun Yat-sen Memorial Hospital of Sun Yat-sen University. Preoperative frailty was assessed using the FRAIL questionnaire. Binary logistics regression analysis was employed to identify factors influencing frailty， and Cox regression analysis was used to evaluate the effect of frailty on survival. According to the demographic characteristics， subgroup analyses were performed on the effect of frailty on prognosis of patients with pancreatic cancer with pancreaticoduodenectomy. ResultsAmong the 435 patients enrolled， 119 （27.4%） exhibited frailty， while 316 （72.6%） did not. Significant differences were observed between the two groups in various clinical parameters， including age， body mass index， American Society of Anesthesiologists （ASA） score， postoperative red blood cell transfusion， postoperative abdominal abscess， serum levels of glycoantigens 199， glycoantigens 125， and alpha fetoprotein， leukocyte count， neutrophil， high density lipoprotein （HDL） level， and pain intensity （P＜0.05）. Advanced age and an ASA score of Ⅲ were identified as risk factors for frailty， whereas HDL level was a protective factor. Non-frail patients had better postoperative survival times than frail patients. HDL was determined to be an independent protective factor for prognosis， while LDL was an independent risk factor. ConclusionsThis study demonstrates that preoperative frailty is a significant predictor of poor prognosis in pancreatic cancer patients who underwent pancreaticoduodenectomy.These findings suggest that preoperative frailty assessment and targeted interventions to improve nutritional and metabolic status could potentially enhance postoperative survival and quality of life in pancreatic cancer patients.
