Validation of the Japanese National Clinical Database Risk calculator for lung cancer surgery focused on postoperative morbidity

Abstract Background Many authors have investigated the possible adverse effects among patients who underwent elective surgery on Friday when compared with patients operated earlier in the week. Nonetheless, the weekday effect is still a matter of debate. This study aimed at investigating the postoperative morbidity rates after lung cancer surgery and their relationship with the weekday the surgery took place. Materials and Methods We retrospectively reviewed the clinical records of patients who underwent elective thoracotomic lobectomies for lung cancer. Categorical data were analyzed using the chi-square test or Fisher's exact test. Association between predictors and binary outcomes while considering the weekday stratification was determined with Cochran–Mantel–Haenszel statistics. To characterize the typical Friday patient, a multiple logistic regression analysis was performed. Results A total of 817 patients (2015–2019) were identified. Complication rates divided by day of surgery were 164 (20.07%) for patients operated on Mondays, 182 (22.27%) on Tuesdays, 205 (25.09%) on Wednesdays, 172 (21.05%) on Thursdays, and 94 (11.51%) on Fridays. Crude morbidity rates by weekday were Monday 21.53%, Tuesday 20.51%, Wednesday 27.70%, Thursday 20.0%, and Friday 10.26%. No overall association between day of surgery and overall morbidity was found (ρ = 0.095). Median hospital length of stay was 5 days (range: 2–45 days), and there were no statistically significant differences between days. The Cochran–Mantel–Haenszel statistics showed no association between morbidity and the weekday. Conclusion In patients undergoing elective lobectomies for lung cancer, the weekday of surgery was not statistically significantly associated with an increase in the risk of postoperative morbidity.

Download Full-text

Can the Japanese National Clinical Database risk calculator predict long-term survival of patients who undergo palliative segmentectomy for primary lung cancer?

General Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-021-01585-6 ◽

2021 ◽

Author(s):

Tomoyuki Nakano ◽

Hiroyoshi Tsubochi ◽

Mitsuru Maki ◽

Kentaro Minegishi ◽

Tomoki Shibano ◽

...

Keyword(s):

Lung Cancer ◽

Thoracoscopic Surgery ◽

Primary Lung Cancer ◽

Risk Calculator ◽

Clinical Database ◽

National Clinical Database ◽

Term Survival ◽

Limited Surgery ◽

Long Term Prognosis

Abstract Objectives Selection criteria for palliative limited surgery in patients with non-small cell lung cancer (NSCLC) can vary by institution or surgeon. We retrospectively reviewed outcomes of poor-risk patients who underwent palliative segmentectomy (PS), using the National Clinical Database Risk Calculator (RC). Methods We retrospectively analyzed medical records of patients with NSCLC tumors ≥ 20 mm and consolidation/tumor ratios ≥ 0.5 on computed tomography, who underwent PS from January 2009 to March 2016. Median follow-up time was 47 months (range 2–102 months). Results We enrolled 67 patients (median age: 73.0 years), of whom 54 received thoracoscopic surgery and 28 received medial lymph-node dissection. The RC’s mean predictive probability rate for perioperative mortality or severe complications was 7.1%. Of the 67 patients, 24 patients (43.0%) suffered post-surgical complications, including 2 (3%) who died in hospital; 17 eventually suffered NSCLC recurrences and/or metastases, 11 eventually died from NSCLC, and 17 died from other diseases. Five-year overall survival (OS) was 59.4%. When the patients were divided into high-risk (HR) and low-risk (LR) groups based on the RC, 5-year OS was significantly less in the HR group (43.9%) than in the LR group (82.2%; P < 0.05). Conclusion The RC, which was developed primarily to determine perioperative risk, can predict long-term prognosis for compromised patients who undergo PS.

Download Full-text

Cardiopulmonary Exercise Test parameters as predictors of postoperative morbidity in lung cancer surgery

10.1183/13993003.congress-2018.pa2763 ◽

2018 ◽

Author(s):

Ana Maria Fortuna Gutierrez ◽

Marta Lenczewska ◽

J.C. Trujillo Reyes ◽

Elizabeth Martinez Tellez ◽

Nuria Calaf Sordo ◽

...

Keyword(s):

Lung Cancer ◽

Exercise Test ◽

Postoperative Morbidity ◽

Lung Cancer Surgery ◽

Cardiopulmonary Exercise Test ◽

Cancer Surgery ◽

Cardiopulmonary Exercise ◽

Test Parameters

Download Full-text

Analysis of Risk Factors for Postoperative Complications in Non-Small Cell Lung Cancer: Comparison With The Japanese National Clinical Database Risk Calculator

10.21203/rs.3.rs-1143493/v1 ◽

2021 ◽

Author(s):

Nozomu Motono ◽

Masahito Ishikawa ◽

Shun Iwai ◽

Aika Yamagata ◽

Yoshihito Iijima ◽

...

Keyword(s):

Risk Factors ◽

Postoperative Morbidity ◽

Pulmonary Resection ◽

Operative Procedure ◽

Significant Risk ◽

Small Cell ◽

Risk Calculator ◽

Clinical Database ◽

Small Cell Lung ◽

National Clinical Database

Abstract Background: Although the risk calculator of the National Clinical Database (RC-NCD) has been widely used to predict the occurrence of mortality and major morbidity in Japan, it has not been demonstrated whether a correlation between the calculated RC-NCD risk score and the actual occurrence of mortality and severe morbidity exists.Methods: The clinical data of 739 patients who underwent pulmonary resection for non-small cell lung cancer were collected, and the risk factors for postoperative morbidity were analyzed to verify the validity of the RC-NCD.Results: The coexistence of asthma (p=0.02), smoking status (p=0.04), forced expiratory volume % in one second (p=0.02), pulmonary lobe (p<0.01), and type of operative procedure (p<0.01) were significant risk factors for postoperative morbidity in the present study, and the body mass index (BMI) (p<0.01) and type of operative procedure (p<0.01) were significant risk factors for severe postoperative morbidity. Furthermore, in patients received lobectomy, coexistence of asthma (p=0.01) and pulmonary lobe (p<0.01) were identified as significant risk factors for postoperative morbidity. Meanwhile, male sex (p=0.01), high BMI (p<0.01),　low vital capacity (p=0.04), and pulmonary lobe (p=0.03) were identified as significant risk factors for severe postoperative morbidity.Conclusions: Given that the pulmonary lobe was a significant risk factor for postoperative morbidity in patients received pulmonary resection and for severe postoperative morbidity in patients received lobectomy, the RC-NCD for postoperative morbidity needs to be modified according to high-risk lobes.Trial registration: The Institutional Review Board of Kanazawa Medical University approved the protocol of this retrospective study (approval number: I392), and written informed consent was obtained from all patients.

Download Full-text