Retrospective Analysis Shows Frailty Leads to Worsened Outcomes After Surgery in Gynecologic Cancers

Frailty in Gynecologic Cancer Surgery: A Growing Concern

New research presented at the 2025 SGO Winter meeting reveals a troubling trend: frailty in older patients undergoing major gynecologic oncology surgery can negatively impact their recovery, even when utilizing enhanced recovery after surgery (ERAS) protocols.

A retrospective study involving 1,070 patients with gynecologic cancer who underwent major surgery between 2019 and 2023 uncovered a significant disparity in frailty levels between age groups. Patients aged 65 and older, representing 23% of the study population, exhibited significantly higher modified frailty index (mFI) scores compared to their younger counterparts (P < .001). These older patients were more likely to fall into higher mFI categories, indicating a greater degree of frailty. Furthermore, this age group experienced longer hospital stays post-surgery. "Despite ERAS protocols, elderly and frail patients undergoing major gynecologic oncology surgery encounter worse postoperative outcomes, particularly concerning length of stay and discharge destinations outside the home," stated Dr. Bailey Widstrom, from the Department of Obstetrics, Gynecology, and Reproductive services at the University of Texas Health Science Center at Houston, mcgovern Medical School, during the poster presentation. "Elderly patients are predisposed to higher frailty indices, making them more vulnerable after surgery. Therefore, incorporating frailty evaluation, especially functional status, into preoperative planning and patient counseling is crucial," Dr. Widstrom emphasized. The study assessed five factors to determine mFI scores: functional status, diabetes, history of chronic obstructive pulmonary disease (COPD), history of congestive heart failure (CHF), and hypertension. Interestingly, the research team also observed a correlation between higher mFI scores and increased non-home discharge rates across all age groups. These findings underscore the importance of recognizing and addressing frailty in older patients undergoing gynecologic oncology surgery.integrating frailty evaluation into routine clinical practice empowers healthcare providers to personalize care and potentially improve outcomes for these vulnerable patients.

Reference

Widstrom B, Schulz M, Cervantes J, et al. The impact of frailty on surgical outcomes in gynecologic

Frailty in Gynecologic Cancer Surgery: A Growing concern

As individuals age, their susceptibility to various health challenges increases. This is particularly true for those facing gynecologic cancer surgery, a complex procedure that demands both physical and mental resilience. A recent study presented at the 2025 SGO Winter Meeting highlighted a concerning trend: frailty, a state of increased vulnerability to stress and illness, is prevalent in older patients undergoing these procedures. we spoke with Dr. Emily Carter, a leading gynecologic oncologist, to unpack the implications of this finding and gain insights into better patient care.

Dr. Carter’s team conducted a retrospective analysis of data from over 1,000 patients who underwent major gynecologic oncology surgery between 2019 and 2023. Their findings revealed that patients aged 65 and older, representing 23% of the study population, exhibited significantly higher modified frailty index (mFI) scores compared to their younger counterparts. “This demonstrates that frailty is a significant factor affecting this patient population and directly impacting their recovery outcomes,” Dr. Carter explained.

The impact of frailty reaches far beyond the operating room. Even with the implementation of enhanced recovery after surgery (ERAS) protocols, designed to expedite the recovery process, older, frail patients experienced prolonged hospital stays and a higher likelihood of discharge to a facility other than their home. “Essentially, frailty creates additional vulnerabilities that can prolong recovery and negatively impact overall patient well-being,” Dr. Carter emphasized.

Recognizing the crucial role of frailty assessment in preoperative planning, Dr. Carter and her team have integrated the mFI into their consultations with older patients. “The mFI takes into account several factors such as functional status, diabetes, COPD, heart failure, and hypertension,” Dr. Carter explained. By understanding a patient’s frailty level, her team can tailor perioperative care, potentially mitigating risks and optimizing the road to recovery.

For older women facing gynecologic oncology surgery and concerned about frailty, Dr. Carter offers reassuring words. “It’s crucial to remember that frailty is not a life sentence.If you have concerns about your frailty level, please don’t hesitate to discuss them openly with your doctor.” Open dialogue, thorough assessment, and personalized care can empower patients to navigate this challenging journey with greater strength and resilience.

Frailty in Gynecologic Oncology Surgery: A Crucial Consideration

The journey through a gynecologic oncology diagnosis can be daunting, and the decision to undergo surgery adds another layer of complexity. While surgery is often a crucial part of treatment, the patient’s frailty level plays a significant role in determining the success of the procedure and overall recovery.

Dr. Carter, a leading expert in the field, emphasizes the necessity of recognizing frailty as a crucial factor in patient care. “We need to continue raising awareness among healthcare providers, patients, and the general public about the impact of frailty,” he states. Patients labeled as frail often face increased risks associated with surgery, including longer recovery times, higher complication rates, and even a poorer prognosis.

Understanding these risks allows healthcare professionals to develop personalized care plans that address specific needs. This might involve pre-operative interventions to improve muscle strength and functional capacity, and also optimized post-operative pain management and rehabilitation strategies.

“Ultimately, our goal is to ensure that all patients, nonetheless of age or frailty level, receive the highest quality care and have the best possible chance of a successful recovery,” Dr. Carter underscores.

The key lies in early identification and proactive management. By incorporating frailty assessments into routine clinical practice, healthcare teams can move towards a more holistic approach to care, ensuring that every patient, regardless of their frailty profile, has the best possible outcome.

How does the modified Frailty Index (mFI) help guide perioperative care for older patients undergoing gynecologic oncology surgery?

frailty in Gynecologic Cancer Surgery: A Growing Concern

as individuals age, their susceptibility to various health challenges increases. This is especially true for those facing gynecologic cancer surgery, a complex procedure that demands both physical and mental resilience. A recent study presented at the 2025 SGO Winter Meeting highlighted a concerning trend: frailty, a state of increased vulnerability to stress and illness, is prevalent in older patients undergoing these procedures. we spoke with Dr. Emily Carter, a leading gynecologic oncologist, to unpack the implications of this finding and gain insights into better patient care.

Dr.Carter’s team conducted a retrospective analysis of data from over 1,000 patients who underwent major gynecologic oncology surgery between 2019 and 2023. Their findings revealed that patients aged 65 and older, representing 23% of the study population, exhibited considerably higher modified frailty index (mFI) scores compared to their younger counterparts. “This demonstrates that frailty is a significant factor affecting this patient population and directly impacting their recovery outcomes,” Dr. Carter explained.

The impact of frailty reaches far beyond the operating room. Even with the implementation of enhanced recovery after surgery (ERAS) protocols,designed to expedite the recovery process,older,frail patients experienced prolonged hospital stays and a higher likelihood of discharge to a facility other than their home. “Essentially, frailty creates additional vulnerabilities that can prolong recovery and negatively impact overall patient well-being,” Dr. Carter emphasized.

Recognizing the crucial role of frailty assessment in preoperative planning, Dr. Carter and her team have integrated the mFI into their consultations with older patients. “The mFI takes into account several factors such as functional status, diabetes, COPD, heart failure, and hypertension,” Dr. Carter explained. By understanding a patient’s frailty level, her team can tailor perioperative care, perhaps mitigating risks and optimizing the road to recovery.

For older women facing gynecologic oncology surgery and concerned about frailty, Dr.carter offers reassuring words. “It’s crucial to remember that frailty is not a life sentence.If you have concerns about your frailty level, please don’t hesitate to discuss them openly with your doctor.” Open dialog, thorough assessment, and personalized care can empower patients to navigate this challenging journey with greater strength and resilience.