Prognostic impact of frailty after gastrectomy in elderly gastric cancer patients

Background Frailty plays a crucial role in cancer patients who have received surgery in this recent aging society. We aimed to investigate frailty as a prognostic factor in elderly gastric cancer (GC) patients who underwent curative gastrectomy. Methods In this study, we analyzed 86 elderly (over 75 years old) GC patients who underwent curative gastrectomy. Frailty was defined as clinical frailty scale score of ≥ 4. Patients were assigned to two groups; frailty group (n = 29) and no-frailty group (n = 57). Clinicopathological values, including comorbidity, immune-nutritional score, and long-term outcomes, were compared between the frailty and no-frailty groups.Results The frailty group displayed a positive correlation with a previous history of symptomatic stroke (p < 0.05). Moreover, the overall survival (OS) rate was significantly poorer in the frailty group (5-yr OS; frailty group 52.09% vs. no-frailty group 72.02%, p < 0.05). By contrast, there were no significant differences in both the cancer-specific survival (5-yr CSS; frailty group 82.33% vs. no-frailty group 89.32%, p = 0.14) and the disease-free survival (5-yr DFS; frailty group 74.68% vs. no-frailty group 86.91%, p = 0.33). Finally, frailty, differentiation, surgical procedure and the lymphocyte c-reactive protein ratio were identified among clinicopathological factors as independent prognostic factors for OS in multivariate analysis. Conclusion We identified the clinical impact of frailty as an independent prognostic factor for elderly GC patients who underwent gastrectomy.