How does frailty impact lung cancer surgery outcomes?

Surgeon Mark Ferguson, MD (Photo: Robert Kozloff/The University of Chicago)


November is Lung Cancer Awareness Month. Lung cancer is the leading cancer killer of both men and women in the United States. At the University of Chicago Medicine Comprehensive Cancer Center, a multidisciplinary team collaborates on cases to ensure patients are getting the most advanced care available. On the research front, experts are developing new tools for early detection and more effective treatment that will be translated into improvements in patient care.

Mark Ferguson, MD, professor of surgery, and his colleagues at the University of Chicago Medicine are skilled in minimally invasive surgery, allowing for shorter hospital stays than traditional operations. They use advanced techniques, such as video-assisted and robotic thoracic surgery, for complex cases of lung cancer.

Ferguson is also conducting research focused on how frailty may influence patient outcomes following complex thoracic surgery. It is likely that frail patients are at higher risk for lung surgery, and using minimally invasive techniques can reduce that risk. One of his goals is to shorten the surgeon learning curve for complex minimally invasive surgical procedures.

Ferguson is using a philanthropic gift from one of his grateful patients, Jeanie Dallas, to continue his work, including one project which will use data from the American College of Surgeons National Surgical Quality Improvement Program to create a unique score for assessing frailty in lung resection patients. Other projects will focus on screening for frailty in thoracic surgery candidates and, in partnership with a group of physicians working on frailty and sarcopenia (the muscle loss that comes with aging), in surgical patients, the development of a strength-training intervention.

Science Life spoke with Ferguson about his project.

Why is it important to assess frailty in patients before thoracic surgery?

This assessment helps determine surgical risk, which is important in discussing treatment options for patients. This knowledge may also help identify patients who might benefit from an intervention such as strength training, which could reduce risk and broaden the treatment options.

How will the scoring system be useful for doctors caring for patients who need surgery? How will it inform their decision-making?

Ultimately we hope that a variety of objective scoring systems are developed that are automated based on measurements of sarcopenia, assessment of estimated postoperative lung function, and degree of frailty. Knowledge of these objective scores improve the accuracy of risk prediction and can help in shared decision making between physicians and their patients and families.

What would the strength-training intervention look like?

A physical therapist would work with a patient several times a week for 4-6 weeks. Training would include strengthening core muscles, arm muscle, leg muscles, and breathing muscles.

What is the goal of your research? Which patients will it help the most?

The overall goal of my research is to make surgical decision making a more conscious and objective process. This will enable surgeons to more accurately predict operative risk and effectively counsel patients based on their anticipated risk and the patient’s personal goals.

About Jane Kollmer (7 Articles)
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