Work

Patient selection and risk stratification for lung resection: a narrative review

Year: 2026

Type: review

Abstract: Background and Objective: ) slope, frailty and sarcopenia. This review synthesises current preoperative risk stratification in light of the 2025 ERS/ESTS guideline and the 2021 American Association for Thoracic Surgery (AATS) expert consensus. Methods: We searched PubMed/MEDLINE for English-language literature on preoperative risk stratification and patient selection for anatomical lung resection, supplemented by hand-searching of reference lists and prioritising guidelines, randomised trials, systematic reviews and multicentre cohort studies. All numerical data were verified against the original publications. Key Content and Findings: slope above 40 as suggestive of high surgical risk. The AATS consensus independently ranks frailty and functional status above chronological age. Together, these developments support a shift from a binary judgement of operability to a structured process that also determines how to operate, adapting the extent of resection and the surgical approach to the patient's physiological reserve. Conclusions: slope threshold and standardised frailty measurement remain unresolved.

Source: Journal of Thoracic Disease

DOI: 10.21037/jtd-2026-2197

Authors: Leticia Leone Lauricella, Ricardo Mingarini Terra

Institutions: Universidade de São Paulo, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Hospital Israelita Albert Einstein, Instituto do Coração - HCFMUSP

Language: English

Topic: Lung Cancer Diagnosis and Treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7222752737

FWCI:

Cites: 47

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Related to: 10