Hüseyin ÇAKMAK, Elif KESEN, Hakan NOMENOĞLU, Muhammet Ali BEYOĞLU, Göktürk FINDIK
Archives of Current Medical Research - 2026;7(2):287-296
Background: Pneumonectomy is a major surgical procedure for central lung cancers but is associated with high morbidity and mortality. This study aimed to evaluate the association between the Modified Frailty Index-5 (mFI-5) score and major postoperative complications and overall survival in patients undergoing pneumonectomy. Methods: Seventy-four patients who underwent pneumonectomy for non-small cell lung cancer were retrospectively reviewed. Patients undergoing pneumonectomy for benign pathologies or non-NSCLC indications were excluded to maintain a homogeneous oncological cohort. The mFI-5 scores were calculated based on five parameters: diabetes, hypertension, heart failure, COPD, and functional dependence. Major complications were defined as Clavien-Dindo Grade >=3. Independent prognostic factors were identified using multivariable logistic and Cox regression models. Results: The mean age was 59.1 +/- 10.6 years, and 85.1% were male. Major postoperative complications occurred in 28.4% of patients. In multivariable analysis, mFI-5 was not independently associated with major postoperative complications. However, higher mFI-5 scores were independently associated with reduced overall survival (HR = 1.428, p = 0.048). The development of postoperative complications was the sole independent determinant of both intensive care unit and hospital length of stay. Conclusion: The mFI-5 score appears to be a practical and clinically accessible tool for preoperative risk stratification in pneumonectomy candidates. However, given the retrospective design and limited sample size, these findings should be interpreted with caution. mFI-5 may serve as a supportive parameter in identifying high-risk patients and guiding perioperative management strategies.
