Table 1 Guidance for definition of higher risk from surgical complications

Group A

 Suitable for surgery—but at higher risk of complications compared to group B (potentially eligible for SABRTooth)

▪ CPEX—VO₂ max 10–15 L/kg/min

▪ ISWT—walk 250–400 m

▪ Mortality risk from Nottingham score: 6–20 % at 90 days

The patient can be approached for the trial if they meet one or more of these criteria

Group B

 Suitable for surgery—lower risk of complications

▪ CPEX—VO₂ max >15 L/kg/min, anaerobic threshold

▪ ISWT—walk >400 m and without significant desaturation

▪ Predicted post-operative FEV₁ > 50 %

▪ Mortality risk from Nottingham score <6 % at 90 days for lobectomy (it is not anticipated that patients will need a pneumonectomy in this group of peripheral cancers).

Not suitable for the trial

Group C

 Unsuitable for surgery as predicted risk of complications is too high

▪ CPEX—VO₂ max <10 L/kg/min

▪ ISWT—walk <250 m and significant desaturation

▪ Pre-operative FEV₁ < 30 %

▪ Mortality risk from Nottingham score >20 % at 90 days for lobectomy (it is not anticipated that patients will need a pneumonectomy in this group of peripheral cancers).

▪ Reduced ejection fraction (e.g. <40 %) or evidence of ongoing myocardial ischemia

▪ Recent cerebrovascular event (e.g. within 3 months of planned surgery)

Not suitable for the trial