We prospectively validate the efficacy of the frailty discriminant score (FDS) in individuals with urological cancers, as there has been growing importance in evaluating frailty in clinical practice. A prospective, multicenter study was conducted from February 2017 to April 2019. We enrolled 258 patients with urological cancers and 301 community-dwelling participants who were assessed for frailty. Frailty was assessed using FDS that includes ten items, such as physical, mental, and blood biochemical tests. The primary outcome was the non-inferiority (margin 5%) of FDS in discriminating patients with urological cancers from controls (Ctrl). The sensitivity, specificity, and area under the receiver operating characteristic (AUROC) curve for each predictive test were calculated. The secondary endpoints included the prediction of overall survival between patients with urological cancer who have high and low FDS. FDS was significantly higher in patients with urological cancers than that in the Ctrl. The AUROC curves for individuals with non-prostate cancers (such as bladder cancer, upper tract urothelial carcinoma, and renal cell carcinoma; 0.942) and those with prostate cancer (0.943) were within the non-inferior margin. The overall survival values were significantly lower in patients with higher FDS score than in those with lower FDS score. The study met its primary and secondary endpoints. The FDS is a reliable and valid tool for assessing frailty and prognosis in patients with urological cancers.

Medical oncology (Northwood, London, England). 2019 Sep 13*** epublish ***

Osamu Soma, Shingo Hatakeyama, Teppei Okamoto, Naoki Fujita, Itsuto Hamano, Toshikazu Tanaka, Masaki Momota, Tohru Yoneyama, Hayato Yamamoto, Atsushi Imai, Takahiro Yoneyama, Yasuhiro Hashimoto, Kazuaki Yoshikawa, Toshiaki Kawaguchi, Hisao Saitoh, Shigeyuki Nakaji, Tadashi Suzuki, Chikara Ohyama

Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan., Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan. ., Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan., Department of Urology, Mutsu General Hospital, Mutsu, Japan., Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan., Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, Japan., Department of Social Medicine, Hirosaki University School of Medicine, Hirosaki, Japan.