The predictive value of preoperative risk assessments and frailty for surgical complications in lung cancer patients

Purpose To assess the predictive value of frailty and risk assessments for postoperative complications in lung cancer patients, we reviewed various risk indicators: including FEV1, ppoFEV1, the Zubrod performance status, the American Society of Anesthesiologist score, and risk models based on the Japan National Clinical Database (NCD) and the European Society of Thoracic Surgeons (ESTS) database. Methods Patients who underwent elective surgery between April 2016 and May 2019 were enrolled. A statistical analysis was performed to compare any differences among the risk indicators. Results The total number of patients enrolled was 193. Thirteen patients (6.7%) were classified as frail and 28 (14.5%) as pre-frail. Among the various risk indicators, the risk models based on the Japan NCD and the ESTS database revealed statistically significant differences in patients with and without postoperative complications (pvalue < 0.0001 and 0.0049, respectively), although there were no significant differences in frailty. The area under the receiver operating characteristic curve for risk models based on the Japan NCD registry and the ESTS registry was 0.70 and 0.64, respectively. Conclusions Our analyses of a series of lung cancer patients showed that frailty was not a significant predictor of postoperative outcomes, while risk models based on academic society databases were found to have a significant predictive value.