Life expectancy in stomach cancer survivors adjusted for blood-test-based frailty: insights into biological aging.

Frail stomach cancer patients had a 1.4-fold higher risk of both cancer and non-cancer mortality compared to non-frail patients.

• Frailty was assessed using 27 laboratory tests (FI-Lab) and classified as non-frail (lower FI-Lab) and frail (higher FI-Lab).
• Impact of frailty on mortality was estimated by cause-specific Cox regression models with age as the timescale.
• The 1.4-fold higher risk applied to both cancer-specific and non-cancer mortality outcomes.

Frailty affected 31.2% of middle-aged (around age 50) stomach cancer patients in the study population.

• The study included 8,281 patients aged ≥50 diagnosed with stomach cancer in 2007–2018 at the National Cancer Center (NCC).
• Data were extracted from electronic health records.
• Frailty prevalence of 31.2% in middle-aged populations led to larger life expectancy losses than in older age groups.

Life expectancy losses due to frailty were greater in males than females across all ages examined.

• LE losses due to frailty for males at age 50 and 85 were 7.6 and 2.0 years, respectively.
• LE losses due to frailty for females at age 50 and 85 were 6.9 and 1.8 years, respectively.
• Male losses were slightly higher than female losses at both age points.

The mortality risk and life expectancy loss due to frailty were largest in patients with localized (early-stage) stomach cancer.

• At age 50, LE loss in localized stage was 3.9 years for males and 3.0 years for females.
• LE losses in regional stage were less than 2 years for both sexes at age 50.
• LE losses in distant stage were approximately 0.5 years for both sexes.
• This pattern indicates frailty has a progressively smaller impact on LE as disease stage advances.

The area under the survival curve was used as the method to estimate remaining life expectancy adjusted for frailty.

• Frailty was quantified using a Frailty Index based on Laboratory tests (FI-Lab) derived from 27 routine blood tests.
• Patients were diagnosed with stomach cancer between 2007 and 2018 at a single institution (National Cancer Center, NCC).
• The study population consisted of 8,281 patients aged ≥50 years.

FI-Lab-based frailty estimates may support clinical assessment and individualized survivorship care by capturing early signs of biological aging.

• FI-Lab uses routine blood tests, making it feasible for integration into standard clinical workflows.
• The authors suggest frailty-adjusted LE estimates add information beyond standard demographic and clinical staging factors.
• The approach is proposed as a tool for individualized survivorship care planning.