Advances in chemotherapy and radiation oncology notwithstanding, surgery remains the best chance of cure in lung cancer. Pre-operative evaluation is very important to reduce surgery-related mortality and complications. Thoracic surgery scoring system (Thoracoscore) is a recently validated multi-variate instrument with nine parameters and is the first scoring system to predict in-hospital mortality after general thoracic procedures. 1 It was derived from 15,183 patients who underwent thoracic surgery in 59 institutions in Europe. It also seems to predict mid-term mortality after thoracic surgery. 2 Currently, the role of thoracoscore in triaging patients for radical surgery is unclear. The European Respiratory Society (ERS) guidelines 2009 3 recommend that this scoring system should not be used for pre-operative evaluation of individual patients for fitness for lung resection. Instead, it recommends cardiopulmonary exercise testing (CPEX) as the standard test to assess exercise capacity and predict post-operative complications. In
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