Umbrella decision-making model for diagnosis and treatment of elderly lung cancer patients: Construction and practice

Lunxu LIU; Jian ZHOU; Xiang DING; Nan CHEN; Jianxin XUE; Xuelei MA; Ye WANG; Weiya WANG; Liqing PENG; Xin YOU; Minggang SU; Xu CHENG; Jiao WANG; Ning GE; Deying KANG; Yuchen HUANG; Jinghan WANG; Yu TONG; Yaoxi ZHANG; Jirong YUE; Hu LIAO

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Umbrella decision-making model for diagnosis and treatment of elderly lung cancer patients: Construction and practice

VernacularTitle:老年肺癌患者伞形决策诊疗模式构建与实践
Author: Lunxu LIU ¹ ; Jian ZHOU ¹ ; Xiang DING ² ; Nan CHEN ¹ ; Jianxin XUE ³ ; Xuelei MA ³ ; Ye WANG ⁴ ; Weiya WANG ⁵ ; Liqing PENG ⁶ ; Xin YOU ³ ; Minggang SU ⁷ ; Xu CHENG ⁸ ; Jiao WANG ⁹ ; Ning GE ² ; Deying KANG ¹⁰ ; Yuchen HUANG ¹ ; Jinghan WANG ¹ ; Yu TONG ¹ ; Yaoxi ZHANG ¹ ; Jirong YUE ² ; Hu LIAO ¹
Author Information

1. Department of Thoracic Surgery, Institute of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
2. National Clinical Research Center for Geriatrics, Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041,P. R. China
3. Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
4. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
5. Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
6. Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
7. Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
8. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
9. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
10. Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
Publication Type:Journal Article
Keywords: Elderly lung cancer; umbrella decision-making; diagnosis and treatment model; application innovation; clinical practice; multidisciplinary team (MDT); oncological indicators; comprehensive geriatric assessment (CGA)
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):833-839
CountryChina
Language:Chinese
Abstract: With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.