WCLC 2025 - Posters & ePosters-P3.01.44 Comparison of Age-Adjusted Charlson Comorbidity Index and Modified Frailty Index as a Postoperative Prognostic Indicator for Lung Cancer

P3.01.44 Comparison of Age-Adjusted Charlson Comorbidity Index and Modified Frailty Index as a Postoperative Prognostic Indicator for Lung Cancer

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This retrospective study analyzed data from 1,987 patients with non-small cell lung cancer who underwent radical surgery between 2007 and 2012 at a single institution in Tokyo, Japan. The aim was to compare the prognostic utility of two perioperative risk stratification tools: the Age-Adjusted Charlson Comorbidity Index (ACCI), which incorporates both age and comorbidities, and the Modified Frailty Index (mFI-11), which considers comorbidities alone.<br /><br />Patient characteristics showed a mean age of 66 years, with 63.6% male and 59.1% having a smoking history. Most patients (80.5%) underwent lobectomy or more extensive resection, and 73.2% had pathological stage 0-I disease. Adenocarcinoma was the predominant histology (79.6%). The ACCI scores were distributed with 23.2% scoring 2 and 20.9% scoring 5 or more; for the mFI-11, 90% had a score of 1.<br /><br />Univariable and multivariable analyses examined overall survival (OS). Results demonstrated that higher ACCI scores were strongly associated with worse prognosis; patients with ACCI ≥5 had a significantly lower 5-year OS rate (79.8%) and a hazard ratio (HR) of 2.11 (p < 0.0001), establishing ACCI as an independent prognostic factor. Conversely, although higher mFI-11 scores correlated with prognosis in univariable analysis, they did not remain significant in multivariable models (HR 0.96, p=0.92).<br /><br />Other factors independently prognostic for poorer survival included male sex, advanced pathological stage, and presence of lymphatic or vascular invasion. Operative procedure type and histology were not independently predictive.<br /><br />In conclusion, the ACCI, which integrates age and comorbidities, is a more useful prognostic indicator than the mFI-11 in patients undergoing lung cancer surgery. This supports using ACCI for perioperative risk stratification to guide clinical decision-making in an aging lung cancer population with multiple comorbidities.

Asset Subtitle

Masaya Yotsukura

Meta Tag

Speaker Masaya Yotsukura

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

non-small cell lung cancer

radical surgery

Age-Adjusted Charlson Comorbidity Index

Modified Frailty Index

prognostic factors

overall survival

comorbidities

perioperative risk stratification

lung adenocarcinoma

multivariable analysis