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Purpose <p>To assess whether frailty in older adults undergoing colorectal cancer surgery correlates with perioperative complication risks predicted by the Japanese National Clinical Database (NCD) Risk Calculator.</p> Methods <p>The subjects of this retrospective study were 143 patients aged ≥ 75 years, who underwent comprehensive geriatric assessment (CGA) before elective colorectal tumor resection at the NHO Kyushu Cancer Center (2018–2023). Frailty was evaluated using the 10-item CGA Frailty Index (FI-CGA-10) and the Robinson Frailty Score (RFS). Correlation and receiver operating characteristic (ROC) analyses were performed, with validation using descriptive statistics based on cutoff values derived from the ROC analysis.</p> Results <p>The median age of the patients was 80 years and frailty (FI-CGA-10 &gt; 0.35 or RFS &gt; 4) was identified in 29%. Both FI-CGA-10 (<i>r</i> = 0.8086) and RFS (<i>r</i> = 0.7362) showed strong correlations with the predicted postoperative fall risk. ROC analysis identified 52.0% and 46.1% of the patients as having optimal fall risk thresholds for detecting frailty, using FI-CGA-10 and RFS, respectively. Validation showed that patients with a predicted fall risk ≥ 52% had significantly higher rates of receiving palliative treatment, suffering postoperative complications, and not being discharged home.</p> Conclusion <p>The NCD Risk Calculator may serve as a practical surrogate for frailty assessment in older patients undergoing colorectal cancer surgery, particularly in resource-limited settings.</p>

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Evaluation of the Japanese National clinical database risk calculator as a surrogate frailty assessment tool for older adults with colorectal cancer

  • 期刊论文

  • 发表日期：

    2026年1月27日

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  • Masahiko Sugiyama,
  • Tomohiro F. Nishijima,
  • Naomichi Koga,
  • Takahiro Tomino,
  • Takeshi Kurihara,
  • Yuta Kasagi,
  • Yasue Kimura,
  • Keishi Sugimachi,
  • Masaru Morita

摘要

Purpose

To assess whether frailty in older adults undergoing colorectal cancer surgery correlates with perioperative complication risks predicted by the Japanese National Clinical Database (NCD) Risk Calculator.

Methods

The subjects of this retrospective study were 143 patients aged ≥ 75 years, who underwent comprehensive geriatric assessment (CGA) before elective colorectal tumor resection at the NHO Kyushu Cancer Center (2018–2023). Frailty was evaluated using the 10-item CGA Frailty Index (FI-CGA-10) and the Robinson Frailty Score (RFS). Correlation and receiver operating characteristic (ROC) analyses were performed, with validation using descriptive statistics based on cutoff values derived from the ROC analysis.

Results

The median age of the patients was 80 years and frailty (FI-CGA-10 > 0.35 or RFS > 4) was identified in 29%. Both FI-CGA-10 (r = 0.8086) and RFS (r = 0.7362) showed strong correlations with the predicted postoperative fall risk. ROC analysis identified 52.0% and 46.1% of the patients as having optimal fall risk thresholds for detecting frailty, using FI-CGA-10 and RFS, respectively. Validation showed that patients with a predicted fall risk ≥ 52% had significantly higher rates of receiving palliative treatment, suffering postoperative complications, and not being discharged home.

Conclusion

The NCD Risk Calculator may serve as a practical surrogate for frailty assessment in older patients undergoing colorectal cancer surgery, particularly in resource-limited settings.