The prognostic significance of modified frailty index-5 in patients undergoing pneumonectomy for lung cancer

Abstract

OBJECTIVES In some centrally located lung cancers, complete excision of the mass cannot be achieved with parenchymal sparing procedures, and pneumonectomy may be required. The mortality and morbidity rates of pneumonectomy were reported considerably high. Here, we investigated the effectivity of modified frailty index-5 (MFI-5) in patients undergoing pneumonectomy for non-small cell lung cancer (NSCLC). METHODS Data of patients who underwent pneumonectomy for NSCLC between January 2018 and December 2023 were reviewed retrospectively. MFI-5 score was determined by preoperative diabetes mellitus, hypertension, chronic obstructive pulmonary diseases, congestive heart failure, and functional status. The effectiveness of the MFI-5 score for the presence of postoperative major complications and 30-day mortality was investigated by multivariate logistic regression analysis. A p-value less than 0.05 was considered statistically significant. RESULTS A total of 107 patients who met the inclusion criteria were included in the study. Eight (7,5%) of patients were female, and the mean age was 61,4 ± 8,7. MFI-5 score was 0 in 48 patients (44.9%), 1 in 27 patients (25.2%), and 2 in 20 patients (18.7%). Postoperative 30-day mortality was detected in 4 patients (3,7%), and the major complications occurred in 42 patients (39,3%). In multivariate analysis, an MFI-5 score of 2 or higher (p = 0,008, OR: 4,9) was statistically significant for complications, whereas age, gender, side of operation, less than 2 MFI-5 score, tumour diameter, type of surgery, and lymph node metastasis status were not statistically significant (p > 0,05). CONCLUSIONS The MFI-5 score is a significant indicator for predicting major postoperative events in patients who underwent pneumonectomy for NSCLC.