Frailty in patients with lung cancer: a systematic review and meta-analysis

Background: Previous studies regarding prevalence of frailty in patients with lung cancer and mortality in frail patients with lung cancer are inconsistent and require clarification. Research question: What is the prevalence and impact of frailty in patients with lung cancer? Study design and methods: In this systematic review and meta-analysis, we used a combination of free-text terms and medical subject headings (MeSH) terms, according to the database requirements in MEDLINE/PubMed, Scopus, and Cochrane Library from inception until November 15, 2020. Results: A total of 2571 articles were identified, and 16 articles involving 4183 patients were included for the study. The prevalence of frailty in lung cancer was 45 % (95 % confidence interval [CI], 28-61 %; I2 = 99.5 %; p < 0.0001). In patients with lung cancer, frailty was associated with an increased HR for mortality (3.02; 95% CI, 1.88-4.85; p < 0.001). Interpretation: The prevalence of frailty in lung cancer is 45 %, which has a significant negative impact on survival of patients with lung cancer. These results highlight the importance of measurement of frailty, which provides important prognostic information, and may provide opportunities for interventions to improve outcomes in patients with lung cancer.