ArticleGynecologic oncology2026
Longitudinal dynamics of post-diagnosis frailty among older women with ovarian cancer.
Article in Gynecologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveLeading oncology societies recommend assessing pre-treatment frailty to guide care for older adults with cancer. However, frailty may change post-diagnosis. This study characterized post-diagnosis frailty and its association with overall survival among older women with ovarian cancer.
methodsWe included 24,725 women aged 65+ diagnosed with ovarian cancer between 2000 and 2019 from Surveillance, Epidemiology, and End Results (SEER)-Medicare. Frailty was quantified at diagnosis and 1-3 years post-diagnosis using a validated claims-based index. We compared patients' frailty at the beginning and end of each year. At 1, 2, and 3 years post-diagnosis, we fit a Cox proportional hazards model including frailty at diagnosis and current frailty to assess associations with survival.
resultsFrailty distribution at diagnosis was: 7.1% non-frail, 71% pre-frail, 18% mildly frail, 3.4% moderately frail, and 0.9% severely frail. During year 1, 38% of women maintained frailty status, 4% improved, 26% worsened, and 32% died. In years 2-3, some women remained stable while others improved or worsened. There were 21,309 deaths during a median follow-up of 25 months (interquartile range 7-58). Frailty at diagnosis was not associated with survival after adjusting for current frailty (hazard ratios [HRs] for severely frail versus non-frail =0.98, 1.00, 0.76 at 1, 2, 3 years, respectively, all p-values>0.20). Current frailty was strongly associated with survival, and the association increased over time (HRs =2.26, 2.77, 3.70, respectively; all p-values<0.001).
conclusionsPost-diagnosis frailty is dynamic. Current frailty has a stronger association with overall survival compared to frailty at diagnosis. Repeated frailty assessments should be incorporated into clinical practice.
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