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Purpose <p>The Laboratory Frailty Index (FI-lab), derived from routine preoperative laboratory parameters, offers a simple and objective alternative to conventional frailty assessment. However, its clinical relevance in elderly patients undergoing pancreaticoduodenectomy (PD), particularly those with pancreatic ductal adenocarcinoma (PDAC), remains unclear.</p> Methods <p>We retrospectively analyzed 350 patients aged ≥ 65 years who underwent PD between 2012 and 2021. Frailty was defined as FI-lab ≥ 0.40. Short-term outcomes, including major postoperative complications (Clavien–Dindo grade ≥IIIa) and in-hospital mortality, were compared between frail and non-frail patients. The long-term outcomes (overall survival [OS] and disease-free survival [DFS]) were evaluated in 166 patients with PDAC.</p> Results <p>Ninety-seven patients (27.7%) were classified as frail. Frail patients had a lower body mass index, greater intraoperative blood loss, and higher transfusion rates, whereas major complications and mortality rates were comparable between the groups. In patients with PDAC, frailty was associated with shorter OS (27.5 vs. 42.2 months; <i>p</i> = 0.043) and DFS (16.7 vs. 23.4 months; <i>p</i> = 0.046), although it was not an independent prognostic factor.</p> Conclusions <p>FI-lab-defined frailty was not associated with perioperative morbidity or mortality after PD. In patients with PDAC, FI-lab may serve as a supplementary tool for preoperative risk stratification by reflecting their physiological vulnerability.</p>

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Laboratory frailty index in pancreaticoduodenectomy: short-term safety and long-term prognosis

  • 期刊论文

  • 发表日期：

    2026年5月30日

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  • Toshiya Abe,
  • Kohei Nakata,
  • Yusuke Watanabe,
  • Noboru Ideno,
  • Naoki Ikenaga,
  • Masafumi Nakamura

摘要

Purpose

The Laboratory Frailty Index (FI-lab), derived from routine preoperative laboratory parameters, offers a simple and objective alternative to conventional frailty assessment. However, its clinical relevance in elderly patients undergoing pancreaticoduodenectomy (PD), particularly those with pancreatic ductal adenocarcinoma (PDAC), remains unclear.

Methods

We retrospectively analyzed 350 patients aged ≥ 65 years who underwent PD between 2012 and 2021. Frailty was defined as FI-lab ≥ 0.40. Short-term outcomes, including major postoperative complications (Clavien–Dindo grade ≥IIIa) and in-hospital mortality, were compared between frail and non-frail patients. The long-term outcomes (overall survival [OS] and disease-free survival [DFS]) were evaluated in 166 patients with PDAC.

Results

Ninety-seven patients (27.7%) were classified as frail. Frail patients had a lower body mass index, greater intraoperative blood loss, and higher transfusion rates, whereas major complications and mortality rates were comparable between the groups. In patients with PDAC, frailty was associated with shorter OS (27.5 vs. 42.2 months; p = 0.043) and DFS (16.7 vs. 23.4 months; p = 0.046), although it was not an independent prognostic factor.

Conclusions

FI-lab-defined frailty was not associated with perioperative morbidity or mortality after PD. In patients with PDAC, FI-lab may serve as a supplementary tool for preoperative risk stratification by reflecting their physiological vulnerability.