A study on the correlation of preoperative frailty status with quality of life and prognosis in elderly patients undergoing surgery for hepatocellular carcinoma

Abstract

Abstract: Objective:To assess the preoperative frailty status of elderly patients with liver cancer and explore its relationship with postoperative quality of life and prognosis.
Method:A retrospective cohort study was conducted, in which 85 elderly patients with hepatocellular carcinoma who underwent surgical treatment at West China Hospital, Sichuan University between January 2022 and January 2023 were selected as study subjects using the random number table method. The Fried frailty scale was used to assess the preoperative frailty status of patients. The quality of life scale for liver cancer patients (QOL-LCV2.0) was used to assess the patients' quality of life 3 months after surgery. The relationship between the Fried score and the QOL-LCV2.0 score was analysed using a fitted curve. The relationship between frailty and overall survival rate and recurrence-free survival rate was analysed using the Kaplan-Meier survival curve. Univariate and multivariate Cox risk regression analysis was used to analyse the risk factors for recurrence and death in patients.
Results:Of the 85 elderly patients with liver cancer, 26 (31%) were frail. The frail patients had higher age, diabetes, alcohol consumption, Child-Pugh classification (Grade B), maximum tumour diameter, number of tumours (multiple) and lower body mass index than the non-frail patients (all P<0.05). The length of stay, time to first ambulation and total complication rate of frail patients were higher than those of non- frail patients (all P<0.05). Three months after surgery, the QOL-LCV2.0 score of frail patients was lower than that of non- frail patients (P<0.05). Fitting curve analysis showed that the Fried score was negatively correlated with the QOL-LCV2.0 total score, QOL-LCV2.0 somatic function, QOL-LCV2.0 psychological function, QOL-LCV2.0 adverse symptoms, and QOL-LCV2.0 social support (all P<0.05). The overall survival rate and recurrence-free survival rate of frail patients were lower than those of non-frail patients (all P<0.05). Univariate and multivariate Cox risk regression results showed that frailty was an independent risk factor for recurrence and death in patients (all P<0.05).
Conclusion:Elderly patients with liver cancer have a high risk of preoperative frailty, which is closely related to postoperative low quality of life and poor prognosis.

Key words: Elderly, Liver cancer, Frailty, Quality of life, Prognosis

Ling Yuanchun, Feng Jinhua, Xu Ruihua, Li Zhenghua, Fan Meiling, Feng Huan, Chen Fang, Han Qiang, Zhao Huijie. A study on the correlation of preoperative frailty status with quality of life and prognosis in elderly patients undergoing surgery for hepatocellular carcinoma[J]. Electronic Journal of Liver Tumor, 2026, 13(3): 77-83.

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