Beyond Chronological Age: Performance Status and Clinical Frailty Predict Survival in Saudi Geriatric Lymphoma Patients: A Competing Risk Analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: To evaluate the prognostic impact of performance status, frailty, and treatment intensity on survival outcomes in a geriatric lymphoma cohort using a competing risk framework. In Saudi Arabia, despite a growing aging population, there is a lack of literature detailing frailty or survival dynamics for geriatric lymphoma patients.Methods: We conducted retrospective cohort study in Tertiary center in Riyadh, Saudi Arabia. Geriatric patients (≥ 60 years) diagnosed with lymphoma during 2011–2024 were analyzed. Baseline demographics, laboratory parameters, pathology, and frailty status were extracted. Survival dynamics were modeled using cumulative incidence functions to isolate lymphoma-related mortality (LRM) from age-related competing risks (ACR). Independent predictors of overall survival and time to progression were determined via multivariate Cox proportional hazards regression models.Results: The sample included 139 patients, with a median age of 72 years; 93% had non-Hodgkin lymphoma. The 5-year cumulative incidence of LRM was 35.6%, while ACR was 5%. In multivariate analyses, poor performance status was a dominant independent predictor of death (hazard ratio [HR] = 2.51; p = 0.01); age did not reach statistical significance. Withholding chemotherapy carried a mortality HR of 2.47 (p = 0.08), whereas a reduced-dose strategy protected against competing risks without compromising survival, as compared to full-dose protocols (p = 0.81).Conclusion: Performance status is an independent prognosticator in geriatric lymphoma. Attenuated-dose therapeutic protocols may represent a safe strategy that does not compromise survival.
Source: Saudi Medical Journal
Authors: Musa Fares Alzahrani, Ghazi S. Alotaibi, Sarah S. Sewaralthahab, Fatima A. Alshalati, Ibrahim N. Alrumaih, Badraa A. Muharib, Kazi Nur Asfina, Saleh Ahmed Alkholaif, Shaden A. Albassam, Saleh Abdullah Aljanah, Shahad A. Al Hemidin, Ahmed Y. Jamal, Fadi S. Alakeel, Walid A. Alkeridy, Farjah H. Algahtani, Aamer Aleem
Institutions: King Saud Medical City, King Saud University
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7222660665
FWCI:
Cites:
Cited by:
Related to: