Frailty in head and neck cancer patients: The Pinerolo and Rivoli Hospitals experience

BACKGROUND: The identification of frailty in head and neck cancer patients has obtained the highest importance nowadays. The aim of this study was to assess frailty and outcomes in head and neck cancer patients, by the modified Frailty Index (mFI). METHODS: The cohort consisted of patients who were treated for head and neck cancer between June 2015 and June 2017. The mFI was administered to all patients. Collected data for each patient were: age, gender, frailty status, tumor site, treatment, and complications. RESULTS: The study included 144 patients (mean age 69, 115 males and 29 females). Fifty-seven patients (39.6%) had an mFI of 0, 40 had a mFI Score of 1 (27.8 %), and the remaining 47 subjects (32.6%) presented a mFI Score equal or higher than 2. Overall, 29 (20%) patients experienced a postoperative complication. A statistically significant association between frailty and the presence of complications was found. Patients with a mFI Score ≥2 have four times the probability of having at least one complication with respect to patients with a mFI of 0 (OR=3.98, P value=0.010). CONCLUSIONS: Frailty assessment, rather than age, might become crucial for risk stratification and perioperative counseling.