{ "abstract": "Background: Frailty and low handgrip strength are established markers of limited physiological reserve, but it is uncertain whether their prognostic meaning differs between oncologic and non-oncologic surgery. We examined whether oncologic indication modifies the associations of preoperative frailty and baseline handgrip strength with early postoperative outcomes.\n\nMethods: This secondary analysis used a prospective cohort conducted at participating surgical centers between January 2023 and June 2025. Frailty was classified using the Fried phenotype, and handgrip strength was measured at admission. The primary outcome was prolonged length of stay (LOS >10 days); secondary outcomes were any postoperative complication, major complications, and log-transformed LOS. Effect modification was evaluated using interaction terms in multivariable logistic models adjusted for age and sex. Because no prolonged stays occurred among fit patients in the non-oncologic stratum, categorical frailty models used Firth penalized logistic regression.\n\nResults: Among 222 clinically characterized participants, 118 (53.2%) underwent oncologic surgery. Prolonged LOS occurred in 41/118 (34.7%) oncologic and 7/104 (6.7%) non-oncologic patients. The complete-case primary analysis included 216 patients and 45 events. In an additional ordinal main-effects model, increasing frailty [odds ratio (OR) 2.91 per category, 95% confidence interval (CI) 1.57–5.38], lower handgrip strength (OR 0.95 per kg, 95% CI 0.90–0.99), and oncologic indication (OR 8.97, 95% CI 3.47–23.19) were associated with prolonged LOS. However, categorical frailty-by-oncology interaction was not supported (global p = 0.341), nor was handgrip-strength-by-oncology interaction ( p = 0.739); the joint interaction test was not statistically significant ( p = 0.525). No convincing effect modification was observed for complications or continuous LOS.\n\nConclusions: Oncologic surgery was associated with a substantially higher early postoperative burden, while frailty and handgrip strength retained prognostic relevance. No clear evidence of multiplicative interaction by oncologic indication was detected, but clinically meaningful effect modification cannot be excluded. Physiological reserve assessment should therefore be considered across elective abdominal surgery rather than restricted to the oncologic setting.", "abstract_shown": true, "affiliations": [ "Department of General Surgery and Surgical Oncology, “Saint Wojciech” Hospital, “Nicolaus Copernicus” Health Center", "Department of Surgery, San Camillo Hospital", "General and Specialistic Surgery Department, Emergency General Surgery Unit, Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino", "Department of Medicine, Academy of Applied Medical and Social Sciences-Akademia Medycznych I Spolecznych Nauk Stosowanych (AMiSNS)", "Department for Geriatric Medicine, Clinic Barmelweid AG", "Department of General and Thoracic Surgery, SS. Annunziata University Hospital", "Department of Medical, Oral, and Biotechnological Sciences, G. d’Annunzio University of Chieti", "Bakhutashvili Institute of Medical Biotechnology, Tbilisi State Medical University", "Department of General Surgery, Anesthesia and Urology, Faculty of Medicine, The Hashemite University", "Section of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia", "Department of Surgery, Dnipro State Medical University" ], "article_type": "research article", "arxiv": null, "author_total": 14, "authors": [ { "affs": [ 0 ], "name": "Sergii Girnyi" }, { "affs": [ 1 ], "name": "Francesco Giovinazzo" }, { "affs": [ 2 ], "name": "Elena Montanari" }, { "affs": [ 2 ], "name": "Eugenia Semeraro" }, { "affs": [ 2 ], "name": "Alessandra Marano" }, { "affs": [ 3 ], "name": "Jaroslaw Skokowski" }, { "affs": [ 0 ], "name": "Tomasz Cwalinski" }, { "affs": [ 4 ], "name": "Mathias Schlögl" }, { "affs": [ 5, 6 ], "name": "Mirko Barone" }, { "affs": [ 7 ], "name": "Archil Aladashvili" }, { "affs": [ 8 ], "name": "Mahmoud Al-Balas" }, { "affs": [ 9 ], "name": "Virginia Boccardi" }, { "affs": [ 2 ], "name": "Mauro Santarelli" }, { "affs": [ 3, 8, 10 ], "name": "Luigi Marano" } ], "bibtex": "https://research.draconitic.com/paper/bqpprba20njcj.bib", "cited_by": 0, "doi": "10.3389/fonc.2026.1954486", "fulltext_url": "https://europepmc.org/articles/PMC13716604", "id": "bqpprba20njcj", "issns": [ "2234-943X" ], "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1954486/full", "language": "eng", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Original Research" ], [ "openalex", "2717|Frailty in Older Adults" ] ], "openalex": "W7222251380", "pdf_url": "https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1954486/pdf", "pmcid": "PMC13716604", "pmid": "42959058", "published": "2026-10-15", "publisher": "Frontiers Media SA", "ris": "https://research.draconitic.com/paper/bqpprba20njcj.ris", "sources": [ { "first_seen": "2026-10-30T12:20:13Z", "native_id": "10.3389/fonc.2026.1954486", "source": "crossref", "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1954486/full" }, { "first_seen": "2026-10-31T00:20:41Z", "native_id": "MED:42959058", "source": "europepmc", "url": "https://europepmc.org/article/MED/42959058" }, { "first_seen": "2026-11-01T12:23:52Z", "native_id": "PMC13716604", "source": "pmc", "url": "https://doi.org/10.3389/fonc.2026.1954486" } ], "subjects": [ { "field": "medicine", "origin": "issn:2234-943X", "subfield": "oncology" } ], "title": "Physiological reserve and early recovery across oncologic and non-oncologic abdominal surgery: a prospective multicenter interaction analysis", "title_text": "Physiological reserve and early recovery across oncologic and non-oncologic abdominal surgery: a prospective multicenter interaction analysis", "type": "peer-reviewed", "updated_at": "2026-11-02T12:21:05Z", "url": "https://research.draconitic.com/paper/bqpprba20njcj", "venue": "Frontiers in Oncology", "versions": [] }