European Respiratory Society and European Society of Thoracic Surgeons clinical practice guideline on fitness for curative intent treatment of lung cancer
Alessandro Brunelli, Georgia Hardavella, Rudolf M. Huber, Thierry Berghmans, Armin Frille, Maria Rodriguez, Ilona Tietzova, Lieven Depypere, Riccardo Asteggiano, Tim Batchelor, Adrien Costantini, Dirk De Ruysscher, Valérie Durieux, Corinne Faivre‐Finn, Mark K. Ferguson, Daniël Langer, Nándor Marczin, Blin Nagavci, Nuria Novoa, Cecilia Pompili, Janette Rawlinson, Annemiek Snoeckx, Thomy Tonia, Wouter H. van Geffen, Clare Williams, Edward Caruana, Pınar Akın Kabalak, Ulrich Mansmann, Vincent Fallet, Diego Kauffmann‐Guerrero, Marianne Paesmans, Amani Al Tawil, Nora Alhannoush, Andrew Creamer, Ismini Kourouni, Torsten Blum
Abstract
A multidisciplinary panel of lung cancer experts with a special interest in functional evaluation of lung cancer patients, and lung cancer patient representatives, has been facilitated by the European Society of Thoracic Surgeons and the European Respiratory Society to provide healthcare professionals with practical and up-to-date recommendations for the assessment of patients' fitness for curative intent treatments for lung cancer. The panel formulated four PICO (population, intervention, comparison and outcomes) questions and seven complementary narrative questions. Both types of questions were assigned to groups of at least two experts. A medical librarian conducted the literature searches, and the authors selected relevant studies based on predefined inclusion criteria. Risk of bias was assessed using the QUIPS (Quality in Prognosis Studies) tool. Data were summarised and the certainty of evidence was assessed with GRADE (Grading of Recommendations, Assessment, Development and Evaluations) and the Evidence to Decisions framework was used to formulate recommendations. A series of multidisciplinary recommendations was formulated about the utilisation of pulmonary function tests, split lung function values, exercise tests, cardiologic testing, and the role of prehabilitation, sublobar resections, risk scores and comorbidities in selecting patients for curative intent treatment.