Mild to moderate frailty among older adults does not affect long‐term quality of life or functional outcomes after colon cancer surgery

BACKGROUND: Frailty is known to adversely affect post-operative mortality and morbidity following colorectal cancer resection, but its impact on long-term quality of life and functional outcomes after colon cancer surgery is less clear. This study aims to evaluate the impact of frailty at the time of diagnosis on quality of life, impact on daily activities, and contentment with treatment one year after colon cancer resection. METHOD: Data were obtained from the prospective, multicentre Quality of Life in Colon Cancer (QoLiCOL) study. Patients aged ≥70 years who underwent colon cancer surgery in Region Västra Götaland, Sweden, were collected from the QoLiCOL database (n = 347). Clinical data were retrieved from national quality registries. Frailty was retrospectively assessed by reviewing medical records using the Clinical Frailty Scale-9 (CFS-9), with scores ≥4 classified as frail. Outcomes included self-reported quality of life, treatment-related impact on activities of daily living, and treatment satisfaction one year post-operatively. Directed Acyclic Graphs (DAGs) of variables known to affect the outcome variables were made before analyses, and potential confounders were adjusted for in the final analyses. Comparisons between frail and non-frail groups were performed using ordinal logistic regression and logistic regression, with results reported as odds ratios (OR). RESULTS: The prevalence of frailty in the cohort was 29%, with a median CFS-9 value of 4 (range 4-6) in the frail group, indicating very mild to moderate frailty. No significant differences were observed between frail and non-frail older adults in self-assessed quality of life, treatment-related impact on daily activities or treatment satisfaction one year after surgery. Notably, both groups reported improved quality of life at one year compared with baseline. Only a small proportion of participants (n = 8; 2%) reported not being content with their treatment. CONCLUSION: Among older adults who were alive one year after colon cancer surgery, mild to moderate frailty does not appear to negatively influence long-term quality of life, effect on daily activities, or satisfaction with treatment. Frail and non-frail patients reported similar levels of well-being and contentment with their care one year post-operatively.