Comorbidity in patients undergoing surgery for lung cancer. Do we have an adequate tool to assess it?

In the recent years comorbidity has been discussed as a factor affecting therapeutic decisions, the course of treatment, and prognosis of patients with lung cancer. The aim of the study was 1. to evaluate the occurrence of comorbidities in patients with lung cancer undergoing surgery, and 2. to investigate the utility of Charlson Comorbidity Index (CCI) and Simplified Comorbidity Score (SCS) for preoperative evaluation of Polish patients with lung cancer.

The retrospective study included 476 patients with lung cancer, who underwent surgical treatment. In all patients, data on histopathological type of the tumor, stage, history of smoking, comorbidities, and spirometric parameters were collected. CCI and SCS scores were calculated. The presence of comorbidities was analyzed in relation to sex, histology, and stage of lung cancer. Correlations between CCI and SCS scores and age, number of pack-years, spirometric parameters were assessed.

The most prevalent comorbidities were hypertension (42%), chronic obstructive pulmonary disease (COPD) (22%), coronary heart disease (17%), and diabetes (12%). There were no differences in the distribution of comorbidity depending on the histological type and stage of lung cancer. The CCI and SCS scores showed correlations with age, number of pack-years and spirometric parameters, however, their compounds do not reflect the profile of most prevalent comoribidities.

The burden of comorbidity among patients with lung cancer is significant. Comorbidity should be assessed while considering patients for surgical treatment. However, the CCI and SCS do not seem precise enough for this purpose.