Postoperative frailty change trajectories and influencing factors in patients with esophageal cancer
Zhong Mengyao
Xue Meng
Wei Wei
Liu Lagen
Xia Wenjie
Xia Hongmei
Nie Jiarui
Abstract：Objective To analyze the postoperative frailty change trajectories in patients with esophageal cancer,understand their progression patterns,and explore the influencing factors.Methods A total of 120 esophageal cancer patients admitted to Jiangsu Cancer Hospital from October 2021 to June 2024 were enrolled.The Clinical Frailty Scale(CFS)was used to as-sess their frailty status preoperatively and at 1 month,3 months,and 6 months postoperatively.A growth mixture model(GMM)was employed for change trajectory analysis.Clinical data were compared between patients with persistent or pro-gressive frailty and those with no frailty or frailty improvement.A logistic multivariate model was used to analyze factors in-fluencing the persistence or progression of frailty.Results Using a CFS level≥5 as the criterion for frailty,the incidence of frailty was highest at 1 month postoperatively and then gradually declined.ANOVA results showed that frailty levels signif-icantly increased at 1 month postoperatively,subsequently eased,but had not returned to baseline by 6 months postopera-tively(P<0.001).GMM analysis indicated that the 3C model with free estimation was the optimal model for predicting frailty change trajectories.Model categories 1,2,and 3 were identified as persistent frailty,improved frailty,and progres-sive frailty,respectively,comprising 11(9.20%),81(67.50%),and 28(23.30%)patients.Multivariate analysis demon-strated that age≥65 years,living alone,clinical stage Ⅲa-Ⅲb,receiving neoadjuvant therapy,postoperative chemoradio-therapy,and having nutritional risk were independent risk factors for persistent or progressive postoperative frailty in esoph-ageal cancer patients(P<0.05).Conclusion The incidence of postoperative frailty is high in esophageal cancer patients,manifesting three distinct trajectories:persistence,improvement,and progression.The persistence and progression of frail-ty are influenced by multiple factors,including patient age,living status,clinical stage,treatment strategy,and nutritional status.Clinical attention should be paid to the change trajectories of postoperative frailty and its influencing factors.Individ-ualized management strategies should be developed based on an integrated biopsychosocial medical model to improve patient prognosis.
Keywords：Esophageal cancerFrailtyClinical Frailty ScaleChange trajectoryNutritional risk screeningInfluencing factors
Publication Date：2025-12-20
Online Publishing Date：2026-03-09(First online date of this platform, not the publication date of the document)
Pages：7( 91-97 )