[Comprehensive Preoperative Evaluation of Patients with Lung Cancer]

Area of Science:

• Oncology
• Thoracic Surgery
• Medical Evaluation

Background:

• Surgical resection is a primary curative treatment for non-small cell lung cancer (NSCLC) stages I-III and some small cell lung cancers.
• Complication and mortality rates following lung cancer surgery exhibit significant variability.
• A detailed preoperative assessment is essential for patient selection and risk stratification in lung cancer surgery.

Purpose of the Study:

• To outline a comprehensive preoperative evaluation protocol for lung cancer patients undergoing surgery.
• To establish a risk stratification system for surgical candidates.
• To emphasize the importance of integrating patient values into treatment decisions.

Main Methods:

• Evaluation includes ECOG scoring, cardiac, cerebrovascular, and pulmonary risk assessments (including split function analysis).
• Functional scoring (IADL) is recommended for patients aged 70 years and older.
• Risk stratification categorizes patients into low risk, increased risk, and non-surgical candidates.

Main Results:

• The evaluation protocol aims to identify appropriate surgical candidates and determine the feasible extent of resection.
• Risk stratification identifies distinct patient groups based on predicted surgical complications and mortality.
• Tailored treatment adjustments can be initiated based on the comprehensive evaluation.

Conclusions:

• A thorough preoperative evaluation is vital for optimizing surgical outcomes in lung cancer patients.
• Risk stratification guides the selection of appropriate candidates for lung cancer resection.
• Physician understanding of patient values and social context is crucial for shared decision-making.