Protocol for guidelines on the comprehensive perioperative management of elderly patients with lung cancer (2025)_Chinese Journal of Evidence-Based Medicine

Authors：

LI Daiping ¹ , LIANG Rui ¹ , LI Linlong ¹ , WANG Yang ¹ , YANG Zhongli ¹ , CHEN Nan ² , YUE Jirong ¹ , DONG Birong ¹ ,  LIU Lunxu ² ,  GE Ning ¹

1. Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LIU Lunxu, Email: lunxu_liu@aliyun.com; GE Ning, Email: grace7733@163.com

Keywords：

Elderly; Lung cancer; Perioperative period; Comprehensive management; Protocol

DOI：

10.7507/1672-2531.202505019

Video：

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With the acceleration of population aging in China, the number of elderly patients with lung cancer continues to rise. These patients not only face threats from the tumor itself but also often suffer from multiple chronic diseases and geriatric syndromes, which increase the complexity of perioperative management and surgical risks. To provide standardized perioperative management strategies for elderly lung cancer patients, the guideline aims to reduce postoperative complications and improve patients' quality of life through comprehensive geriatric assessment, comorbidity management, and early identification and intervention of complications. The guideline working group has drafted the "Protocol for Guidelines on the Comprehensive Perioperative Management of Elderly Patients with Lung Cancer (2025)", detailing the development process of the guidelines.

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23.	Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ, 2016, 355: i4919.
24.	Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
25.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
26.	Rostom A, Dubé C, Cranney A, et al. Quality assessment forms. Rockville (MD): Agency for Healthcare Research and Quality (US), 2004.

1. Stieglitz S, Goede V, Schlesinger A. Management of lung cancer in older adults. Z Gerontol Geriatr, 2025, 58(2): 103-108.
2. Inouye SK, Studenski S, Tinetti ME, et al. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc, 2007, 55(5): 780-791.
3. Decoster L, Kenis C, Schallier D, et al. Geriatric assessment and functional decline in older patients with lung cancer. Lung, 2017, 195(5): 619-626.
4. Tsiouris A, Hammoud ZT, Velanovich V, et al. A modified frailty index to assess morbidity and mortality after lobectomy. J Surg Res, 2013, 183(1): 40-46.
5. Korc-Grodzicki B, Downey RJ, Shahrokni A, et al. Surgical considerations in older adults with cancer. J Clin Oncol, 2014, 32(24): 2647-2653.
6. Wong ML, McMurry TL, Schumacher JR, et al. Comorbidity assessment in the national cancer database for patients with surgically resected breast, colorectal, or lung cancer (AFT-01, -02, -03). J Oncol Pract, 2018, 14(10): e631-e643.
7. Shi J, Wu Z, Wang Q, et al. Clinical predictive efficacy of C-reactive protein for diagnosing infectious complications after gastric surgery. Therap Adv Gastroenterol, 2020, 13: 1756284820936542.
8. Park BS, Cho SH, Lee SH, et al. Role of C-reactive protein, white blood cell counts, and serum glucose levels as early predictors of infectious complications after laparoscopic colorectal surgery for colorectal cancer. Am Surg, 2023, 89(12): 5821-5828.
9. 陈旭娇, 严静, 王建业, 等. 中国老年综合评估技术应用专家共识. 中华老年病研究电子杂志, 2017, 4(2): 1-6.
10. 中华医学会肿瘤学分会. 中华医学会肺癌临床诊疗指南(2024版). 中华医学杂志, 2024, 104(34): 3175-3213.
11. 朱鸣雷, 刘晓红, 董碧蓉, 等. 老年共病管理中国专家共识(2023). 中国临床保健杂志, 2023, 26(5): 577-584.
12. World Health Organization. WHO handbook for guideline development. 2nd ed. Vienna: WHO, 2014: 1-167.
13. Schünemann HJ, Wiercioch W, Etxeandia I, 等. 指南2. 0: 为成功制定指南而系统研发的全面清单. 中国循证医学杂志, 2014, 14(9): 1135-1149.
14. 陈耀龙, 杨克虎, 王小钦, 等. 中国制订/修订临床诊疗指南的指导原则(2022版). 中华医学杂志, 2022, 102(10): 697-703.
15. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
16. 拜争刚, 刘少堃, 黄崇斐, 等. 定性系统评价证据分级工具—CERQual简介. 中国循证医学杂志, 2015, 15(12): 1465-1470.
17. Brouwers MC, Kerkvliet K, Spithoff K, et al. The AGREE reporting checklist: a tool to improve reporting of clinical practice guidelines. BMJ, 2016, 352: i1152.
18. 杨楠, 赵巍, 潘旸, 等. 针对临床实践指南科学性、透明性和适用性的评级工具研发. 中华医学杂志, 2022, 102(30): 2329-2337.
19. Chen Y, Yang K, Marušic A, et al. A reporting tool for practice guidelines in health care: the RIGHT statement. Ann Intern Med, 2017, 166(2): 128-132.
20. 陈耀龙, 马艳芳, 周奇, 等. 谁应该参与临床实践指南的制订. 协和医学杂志, 2019, 10(5): 524-530.
21. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
22. Wang Y, Keitz S, Briel M, et al. Development of ROBUST-RCT: risk of bias instrument for use in systematic reviews-for randomised controlled trials. BMJ, 2025, 388: e081199.
23. Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ, 2016, 355: i4919.
24. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
25. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
26. Rostom A, Dubé C, Cranney A, et al. Quality assessment forms. Rockville (MD): Agency for Healthcare Research and Quality (US), 2004.

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