Risk model of in-hospital mortality after pulmonary resection for cancer: A national database of the French Society of Thoracic and Cardiovascular Surgery (Epithor)

Bernard, Alain; Rivera, Caroline; Pagès, P; Falcoz, Pierre‐Emmanuel; Vicaut, Éric; Dahan, M.

doi:10.1016/j.jtcvs.2010.06.044

Cited by 96 publications

(72 citation statements)

References 26 publications

(40 reference statements)

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“…This fall was linked to the decreased use of pneumonectomy over the study period. Although postoperative management improved, major pulmonary resections, such as bi-lobectomy or pneumonectomy, were still burdened by a high mortality rate, due to the gravity of the resection itself, as previously described [14]. Indeed, the effect of pneumonectomy on postoperative mortality and on overall survival was very important, as shown by the high values of the OR and the HR far from the limits of the 95% confidence interval (tables 3 and 4).…”

Section: Postoperative Complications and Mortalitymentioning

confidence: 67%

“…We highlighted that patients became more and more fragile over the study period, with a greater proportion of older patients and of patients presenting three or more comorbidities. This increase in the age and the high number of comorbidities are important, and were identified as predictors of in-hospital mortality by BERNARD et al [14]. As previously described by ALBERG et al [4] the proportion of women increased significantly over time from 24.1 to 30%.…”

Section: Discussionmentioning

confidence: 81%

“…The baseline demographic and clinical characteristics included age, sex, American Society of Anesthesiologists (ASA) score, World Health Organization performance status, body mass index (BMI), the forced expiratory volume as a percentage and the dyspnoea score according to the Medical Research Council. The number of comorbid diseases per patient was considered a categorical variable because recent data from Epithor consistently suggested that this variable was superior to individual comorbidities in a predictive model for operative mortality [14]. Surgery-related variables included the surgical approach (thoracotomy, video assisted thoracic surgery (VATS)), the type of resection (wedge resection, segmentectomy, lobectomy, bi-lobectomy and pneumonectomy), bronchoplasty and the extent of the pulmonary resection (to the chest wall, the left atrium, the carina, the diaphragm, and the superior vena cava).…”

Section: Study Populationmentioning

confidence: 99%

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Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Morgant

Pagès

Orsini³

et al. 2015

Eur Respir J

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The aim of this study was to assess the evolution of survival in patients treated surgically for non-small cell lung cancer (NSCLC) between 2005 and 2012.From January 2005 to December 2012, 34 006 patients underwent pulmonary resection for NSCLC and were included in the French national database Epithor. Patients' characteristics, procedures and survival were analysed. Survival according to the management was evaluated for each 2-year period separately: 2005-2006, 2007-2008, 2009-2010 and 2011-2012.The proportions of early-stage cancers and adenocarcinomas increased significantly over the periods. 3-year overall survival (OS) increased significantly from 80.5% for the first period to 81.4% for the last period. For the periods 2005-2006 and 2007-2008, 3-year OS was lower after segmentectomy than after lobectomy (77 and 73% versus 82 and 83%, respectively). For the periods 2009-2010 and 2011-2012, 3-year OS in the two sub-groups was similar. OS after bi-lobectomy or pneumonectomy was lower than after lobectomy for all periods analysed. Systematic nodal dissection increased OS for all periods. Chemotherapy but not radiotherapy improved OS in the first 12 postoperative months for all periods.Changes in histological type and stage linked to advances in surgical and medical practices since 2005 led to an increase in OS in patients with surgical-stage NSCLC. @ERSpublications Overall survival and postoperative mortality after lung cancer surgery improve over the last decades

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Section: Postoperative Complications and Mortalitymentioning

confidence: 67%

Section: Discussionmentioning

confidence: 81%

Section: Study Populationmentioning

confidence: 99%

See 1 more Smart Citation

Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Morgant

Pagès

Orsini³

et al. 2015

Eur Respir J

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“…% predicted FEV 1 (%FEV 1 ) is correlated with prolonged length of hospital stay, 5) major morbidity, 6) and in-hospital mortality, 7) after surgical resection of lung cancer. Postoperative complications and survival were not directly evaluated in these studies.…”

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confidence: 99%

Worse Prognosis for Stage IA Lung Cancer Patients with Smoking History and More Severe Chronic Obstructive Pulmonary Disease

Yoshida

Kage

Murakawa

et al. 2015

ATCS

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IntroductionLung cancer is the most commonly diagnosed cancer and the leading cause of cancer death in males worldwide. 1) Tobacco smoking is the best established risk factor for lung cancer and the most common risk factor for chronic obstructive lung disease (COPD). 2) COPD is the fourth leading cause of death worldwide and occurs in 30% of patients with lung cancer. 2) Spirometry is used to assess the risk for perioperative death and cardiopulmonary complications after resection of the lung, with a predicted postoperative forced expiratory volume in one second (FEV 1 ) value of 30% indicating a high risk. 3,4) Purpose: This retrospective study examined whether the severity of chronic obstructive lung disease (COPD) affects surgical outcomes. Methods: The subjects were 243 consecutive patients who underwent lobectomy for clinical stage IA lung cancer from 1999 to 2008 in our hospital. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading system was used to classify the severity of COPD in smokers. Results: Among the 149 smokers, 62 were diagnosed with COPD (25 as GOLD 1, 33 as GOLD 2, and 4 as GOLD 3). In univariate analysis, postoperative pulmonary complications were associated with male sex and more severe COPD. The frequencies were 17.1% in non-COPD, 24.0% in GOLD 1-COPD, and 46.0% in GOLD 2/3-COPD smokers (p = 0.0006). In univariate analysis, older age, smoking history, higher smoking pack-years and more severe COPD were associated with poor relapse-free survival. Relapse-free survival at five years was 80.7%, 66.9%, and 61.3% in non-COPD, GOLD 1-COPD, and GOLD 2/3-COPD smokers, respectively (p = 0.0005). Multivariate analyses showed that only GOLD 2/3-COPD was associated with postoperative pulmonary complications and relapse-free survival. Inhaled bronchodilators were prescribed preoperatively to 24.3% of the GOLD 2/3-COPD group. Conclusion: Smokers with GOLD 2/3-COPD are at high risk for pulmonary complications and have an unfavorable long-term prognosis.

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“…There are, however, databases, which were used to produce risk models that are successfully used by thoracic surgeons worldwide. The first of them is the Thoracoscore, derived from the national French database, Epithor (1). The second to be mention is the database of the Society of Thoracic Surgeons (2).…”

mentioning

confidence: 99%

Surgical risk models: how they contribute to improvement of our treatments?

Włodarczyk

Kużdżał

2017

J. Thorac. Dis.

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Risk model of in-hospital mortality after pulmonary resection for cancer: A national database of the French Society of Thoracic and Cardiovascular Surgery (Epithor)

Abstract: Our preference is for the well-calibrated model 2 because it is easier to use in practice to estimate the adjusted postoperative mortality of lung resections for cancer.

Cited by 96 publications

References 26 publications

Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Time trends in surgery for lung cancer in France from 2005 to 2012: a nationwide study

Worse Prognosis for Stage IA Lung Cancer Patients with Smoking History and More Severe Chronic Obstructive Pulmonary Disease

Surgical risk models: how they contribute to improvement of our treatments?

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