Modified Frailty Index Predicts Prognosis in Patients With Gastric Cancer After Gastrectomy: A Systematic Review and Meta-Analysis

Abstract

Background: The predictive ability of the modified frailty index (mFI) for postoperative outcomes and survival in patients with gastric cancer (GC) remains uncertain. Methods: Studies were retrieved from 11 electronic databases. Odds ratio (OR) and 95% confidence intervals (CIs) were used to report surgical outcomes, including overall survival (OS), complications, mortality, readmission, and nonhome discharge. The fixed or random effects model was used depending on the heterogeneity. Subgroup and meta-regression analyses were performed to determine the source of heterogeneity. Results: This meta-analysis of 13 studies, including 15 359 GC patients, showed that high mFI scores were associated with reduced OS (OR = 1.35) and increased risk of poor postoperative outcomes (OR = 2.61). The older patients with higher mFI scores had a higher risk of worse OS after gastrectomy (OR = 1.69). Conclusions: This study demonstrated that high mFI scores were strongly associated with reduced OS and increased risk of poor outcomes following surgery in patients with GC, with a more than two-fold increase in the overall risk of poor outcomes. Compared to other tools, the mFI is easy to operate, making it an effective tool for prognosis assessment and personalized treatment and care planning. Trial Registration: PROSPERO (Registration Number: CRD42024613727).