A proposal for a comprehensive risk scoring system for predicting postoperative complications in octogenarian patients with medically operable lung cancer: JACS1303
Abstract OBJECTIVES Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial. METHODS The Japanese Association for Chest Surg...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2018-04, Vol.53 (4), p.835-841 |
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| creator | Saji, Hisashi Ueno, Takahiko Nakamura, Hiroshige Okumura, Norihito Tsuchida, Masanori Sonobe, Makoto Miyazaki, Takuro Aokage, Keiju Nakao, Masayuki Haruki, Tomohiro Ito, Hiroyuki Kataoka, Kazuhiko Okabe, Kazunori Tomizawa, Kenji Yoshimoto, Kentaro Horio, Hirotoshi Sugio, Kenji Ode, Yasuhisa Takao, Motoshi Okada, Morihito Chida, Masayuki |
| description | Abstract
OBJECTIVES
Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial.
METHODS
The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications.
RESULTS
Operative (30 days) and hospital mortality rates were 1.0% and 1.6%, respectively. Complications were observed in 308 (34%) patients, of whom 81 (8.4%) had Grade 3–4 severe complications. Pneumonia was the most common severe complication, observed in 27 (3.0%) patients. Five predictive factors, gender, comprehensive geriatric assessment75: memory and Simplified Comorbidity Score (SCS): diabetes mellitus, albumin and percentage vital capacity, were identified as independent predictive factors for severe postoperative complications (odds ratio = 2.73, 1.86, 1.54, 1.66 and 1.61, respectively) through univariate and multivariate analyses. A 5-fold cross-validation was performed as an internal validation to reconfirm these 5 predictive factors (average area under the curve 0.70). We developed a simplified RS system as follows: RS = 3 (gender: male) + 2 (comprehensive geriatric assessment 75: memory: yes) + 2 (albumin: |
| doi_str_mv | 10.1093/ejcts/ezx415 |
| format | Article |
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OBJECTIVES
Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial.
METHODS
The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications.
RESULTS
Operative (30 days) and hospital mortality rates were 1.0% and 1.6%, respectively. Complications were observed in 308 (34%) patients, of whom 81 (8.4%) had Grade 3–4 severe complications. Pneumonia was the most common severe complication, observed in 27 (3.0%) patients. Five predictive factors, gender, comprehensive geriatric assessment75: memory and Simplified Comorbidity Score (SCS): diabetes mellitus, albumin and percentage vital capacity, were identified as independent predictive factors for severe postoperative complications (odds ratio = 2.73, 1.86, 1.54, 1.66 and 1.61, respectively) through univariate and multivariate analyses. A 5-fold cross-validation was performed as an internal validation to reconfirm these 5 predictive factors (average area under the curve 0.70). We developed a simplified RS system as follows: RS = 3 (gender: male) + 2 (comprehensive geriatric assessment 75: memory: yes) + 2 (albumin: <3.8 ng/ml) + 1 (percentage vital capacity: ≤90) + 1 (SCS: diabetes mellitus: yes).
CONCLUSIONS
The current series shows that octogenarians can be successfully treated for lung cancer with surgical resection with an acceptable rate of severe complications and mortality. We propose a simplified RS system to predict severe complications in octogenarian patients with medically operative lung cancer.
Trial Registration Number
JACS1303 (UMIN000016756)</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezx415</identifier><identifier>PMID: 29240884</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>Age Factors ; Aged, 80 and over ; Female ; Hospital Mortality ; Humans ; Lung Neoplasms - mortality ; Lung Neoplasms - surgery ; Male ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Prospective Studies ; Risk Assessment - methods ; Risk Factors ; Sex Factors ; Smoking - adverse effects</subject><ispartof>European journal of cardio-thoracic surgery, 2018-04, Vol.53 (4), p.835-841</ispartof><rights>2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-318aa2653d4d36dc6003ee15da0936a8fa0811c845096ec2b670801ea64e02553</citedby><cites>FETCH-LOGICAL-c361t-318aa2653d4d36dc6003ee15da0936a8fa0811c845096ec2b670801ea64e02553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1579,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29240884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saji, Hisashi</creatorcontrib><creatorcontrib>Ueno, Takahiko</creatorcontrib><creatorcontrib>Nakamura, Hiroshige</creatorcontrib><creatorcontrib>Okumura, Norihito</creatorcontrib><creatorcontrib>Tsuchida, Masanori</creatorcontrib><creatorcontrib>Sonobe, Makoto</creatorcontrib><creatorcontrib>Miyazaki, Takuro</creatorcontrib><creatorcontrib>Aokage, Keiju</creatorcontrib><creatorcontrib>Nakao, Masayuki</creatorcontrib><creatorcontrib>Haruki, Tomohiro</creatorcontrib><creatorcontrib>Ito, Hiroyuki</creatorcontrib><creatorcontrib>Kataoka, Kazuhiko</creatorcontrib><creatorcontrib>Okabe, Kazunori</creatorcontrib><creatorcontrib>Tomizawa, Kenji</creatorcontrib><creatorcontrib>Yoshimoto, Kentaro</creatorcontrib><creatorcontrib>Horio, Hirotoshi</creatorcontrib><creatorcontrib>Sugio, Kenji</creatorcontrib><creatorcontrib>Ode, Yasuhisa</creatorcontrib><creatorcontrib>Takao, Motoshi</creatorcontrib><creatorcontrib>Okada, Morihito</creatorcontrib><creatorcontrib>Chida, Masayuki</creatorcontrib><creatorcontrib>Committee for Scientific Affairs, The Japanese Association for Chest Surgery, Tokyo, Japan</creatorcontrib><title>A proposal for a comprehensive risk scoring system for predicting postoperative complications in octogenarian patients with medically operable lung cancer: JACS1303</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>Abstract
OBJECTIVES
Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial.
METHODS
The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications.
RESULTS
Operative (30 days) and hospital mortality rates were 1.0% and 1.6%, respectively. Complications were observed in 308 (34%) patients, of whom 81 (8.4%) had Grade 3–4 severe complications. Pneumonia was the most common severe complication, observed in 27 (3.0%) patients. Five predictive factors, gender, comprehensive geriatric assessment75: memory and Simplified Comorbidity Score (SCS): diabetes mellitus, albumin and percentage vital capacity, were identified as independent predictive factors for severe postoperative complications (odds ratio = 2.73, 1.86, 1.54, 1.66 and 1.61, respectively) through univariate and multivariate analyses. A 5-fold cross-validation was performed as an internal validation to reconfirm these 5 predictive factors (average area under the curve 0.70). We developed a simplified RS system as follows: RS = 3 (gender: male) + 2 (comprehensive geriatric assessment 75: memory: yes) + 2 (albumin: <3.8 ng/ml) + 1 (percentage vital capacity: ≤90) + 1 (SCS: diabetes mellitus: yes).
CONCLUSIONS
The current series shows that octogenarians can be successfully treated for lung cancer with surgical resection with an acceptable rate of severe complications and mortality. We propose a simplified RS system to predict severe complications in octogenarian patients with medically operative lung cancer.
Trial Registration Number
JACS1303 (UMIN000016756)</description><subject>Age Factors</subject><subject>Aged, 80 and over</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Prospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Smoking - adverse effects</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAURi3Uiv7uWCPvyoK013HiOOxGIyhUlVhApe4ij3OndevYwXaA6fPwoDgzLUtWtq_OdyTfj5A3DM4ZtPwCH3SKF_j0u2L1K3LIZMOLhle3e_kODIqmreCAHMX4AACCl81rclC2ZQVSVofkz4KOwY8-KkvXPlBFtR_GgPfoovmJNJj4SKP2wbg7Gjcx4bDlMtIbneZpDic_YlBpDsxxa3R-eBepcdTr5O_QqWCUo2Oeo0uR_jLpng6zQ1m7odv8yiK1UzZq5TSGD_RqsfzGOPATsr9WNuLp83lMbj59_L78XFx_vfyyXFwXmguWCs6kUqWoeV_1XPRaAHBEVvcq70kouVYgGdOyqqEVqMuVaEACQyUqhLKu-TF5t_PmlfyYMKZuMFGjtcqhn2LH2qZppIC6zej7HaqDjzHguhuDGVTYdAy6uZdu20u36yXjb5_N0yr_-h_8UkQGznaAn8b_q_4Cw16bgQ</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Saji, Hisashi</creator><creator>Ueno, Takahiko</creator><creator>Nakamura, Hiroshige</creator><creator>Okumura, Norihito</creator><creator>Tsuchida, Masanori</creator><creator>Sonobe, Makoto</creator><creator>Miyazaki, Takuro</creator><creator>Aokage, Keiju</creator><creator>Nakao, Masayuki</creator><creator>Haruki, Tomohiro</creator><creator>Ito, Hiroyuki</creator><creator>Kataoka, Kazuhiko</creator><creator>Okabe, Kazunori</creator><creator>Tomizawa, Kenji</creator><creator>Yoshimoto, Kentaro</creator><creator>Horio, Hirotoshi</creator><creator>Sugio, Kenji</creator><creator>Ode, Yasuhisa</creator><creator>Takao, Motoshi</creator><creator>Okada, Morihito</creator><creator>Chida, Masayuki</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180401</creationdate><title>A proposal for a comprehensive risk scoring system for predicting postoperative complications in octogenarian patients with medically operable lung cancer: JACS1303</title><author>Saji, Hisashi ; Ueno, Takahiko ; Nakamura, Hiroshige ; Okumura, Norihito ; Tsuchida, Masanori ; Sonobe, Makoto ; Miyazaki, Takuro ; Aokage, Keiju ; Nakao, Masayuki ; Haruki, Tomohiro ; Ito, Hiroyuki ; Kataoka, Kazuhiko ; Okabe, Kazunori ; Tomizawa, Kenji ; Yoshimoto, Kentaro ; Horio, Hirotoshi ; Sugio, Kenji ; Ode, Yasuhisa ; Takao, Motoshi ; Okada, Morihito ; Chida, Masayuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-318aa2653d4d36dc6003ee15da0936a8fa0811c845096ec2b670801ea64e02553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age Factors</topic><topic>Aged, 80 and over</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Prospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Smoking - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saji, Hisashi</creatorcontrib><creatorcontrib>Ueno, Takahiko</creatorcontrib><creatorcontrib>Nakamura, Hiroshige</creatorcontrib><creatorcontrib>Okumura, Norihito</creatorcontrib><creatorcontrib>Tsuchida, Masanori</creatorcontrib><creatorcontrib>Sonobe, Makoto</creatorcontrib><creatorcontrib>Miyazaki, Takuro</creatorcontrib><creatorcontrib>Aokage, Keiju</creatorcontrib><creatorcontrib>Nakao, Masayuki</creatorcontrib><creatorcontrib>Haruki, Tomohiro</creatorcontrib><creatorcontrib>Ito, Hiroyuki</creatorcontrib><creatorcontrib>Kataoka, Kazuhiko</creatorcontrib><creatorcontrib>Okabe, Kazunori</creatorcontrib><creatorcontrib>Tomizawa, Kenji</creatorcontrib><creatorcontrib>Yoshimoto, Kentaro</creatorcontrib><creatorcontrib>Horio, Hirotoshi</creatorcontrib><creatorcontrib>Sugio, Kenji</creatorcontrib><creatorcontrib>Ode, Yasuhisa</creatorcontrib><creatorcontrib>Takao, Motoshi</creatorcontrib><creatorcontrib>Okada, Morihito</creatorcontrib><creatorcontrib>Chida, Masayuki</creatorcontrib><creatorcontrib>Committee for Scientific Affairs, The Japanese Association for Chest Surgery, Tokyo, Japan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saji, Hisashi</au><au>Ueno, Takahiko</au><au>Nakamura, Hiroshige</au><au>Okumura, Norihito</au><au>Tsuchida, Masanori</au><au>Sonobe, Makoto</au><au>Miyazaki, Takuro</au><au>Aokage, Keiju</au><au>Nakao, Masayuki</au><au>Haruki, Tomohiro</au><au>Ito, Hiroyuki</au><au>Kataoka, Kazuhiko</au><au>Okabe, Kazunori</au><au>Tomizawa, Kenji</au><au>Yoshimoto, Kentaro</au><au>Horio, Hirotoshi</au><au>Sugio, Kenji</au><au>Ode, Yasuhisa</au><au>Takao, Motoshi</au><au>Okada, Morihito</au><au>Chida, Masayuki</au><aucorp>Committee for Scientific Affairs, The Japanese Association for Chest Surgery, Tokyo, Japan</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A proposal for a comprehensive risk scoring system for predicting postoperative complications in octogenarian patients with medically operable lung cancer: JACS1303</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>53</volume><issue>4</issue><spage>835</spage><epage>841</epage><pages>835-841</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>Abstract
OBJECTIVES
Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial.
METHODS
The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications.
RESULTS
Operative (30 days) and hospital mortality rates were 1.0% and 1.6%, respectively. Complications were observed in 308 (34%) patients, of whom 81 (8.4%) had Grade 3–4 severe complications. Pneumonia was the most common severe complication, observed in 27 (3.0%) patients. Five predictive factors, gender, comprehensive geriatric assessment75: memory and Simplified Comorbidity Score (SCS): diabetes mellitus, albumin and percentage vital capacity, were identified as independent predictive factors for severe postoperative complications (odds ratio = 2.73, 1.86, 1.54, 1.66 and 1.61, respectively) through univariate and multivariate analyses. A 5-fold cross-validation was performed as an internal validation to reconfirm these 5 predictive factors (average area under the curve 0.70). We developed a simplified RS system as follows: RS = 3 (gender: male) + 2 (comprehensive geriatric assessment 75: memory: yes) + 2 (albumin: <3.8 ng/ml) + 1 (percentage vital capacity: ≤90) + 1 (SCS: diabetes mellitus: yes).
CONCLUSIONS
The current series shows that octogenarians can be successfully treated for lung cancer with surgical resection with an acceptable rate of severe complications and mortality. We propose a simplified RS system to predict severe complications in octogenarian patients with medically operative lung cancer.
Trial Registration Number
JACS1303 (UMIN000016756)</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>29240884</pmid><doi>10.1093/ejcts/ezx415</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 1010-7940 1873-734X |
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| subjects | Age Factors Aged, 80 and over Female Hospital Mortality Humans Lung Neoplasms - mortality Lung Neoplasms - surgery Male Postoperative Complications - epidemiology Postoperative Complications - etiology Prospective Studies Risk Assessment - methods Risk Factors Sex Factors Smoking - adverse effects |
| title | A proposal for a comprehensive risk scoring system for predicting postoperative complications in octogenarian patients with medically operable lung cancer: JACS1303 |
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