J Korean Med Sci.  2022 Feb;37(5):e36. 10.3346/jkms.2022.37.e36.

Predicting Postoperative Complications and Long-Term Survival After Lung Cancer Surgery Using Eurolung Risk Score

• Yun JK
• Jeong JH
• Lee GD
• Kim HR
• Kim YH
• Kim DK
• Park SI
• Choi S

• KMID: 2525488
• DOI: http://doi.org/10.3346/jkms.2022.37.e36

Abstract

Background
This study aimed to assess the clinical relevance of the parsimonious Eurolung risk scoring system for predicting postoperative morbidity, mortality, and long-term survival in Korean patients with surgically resected non-small cell lung cancer.
Methods
This retrospective analysis used the data of patients who underwent anatomical resection for non-small cell lung cancer between 2004 and 2018 at a single institution. The parsimonious aggregate Eurolung score was calculated for each patient. The Cox regression model was used to determine the ability of the Eurolung scoring system for predicting longterm outcomes.
Results
Of the 7,278 patients in the study, cardiopulmonary complications and mortality occurred in 687 (9.4%) and 53 (0.7%) patients, respectively. The rate of cardiopulmonary complications and mortality gradually increased with the increase in the Eurolung risk scores (all P < 0.001). When risk scores were grouped into four categories, the Eurolung scoring system showed a stepwise deterioration of overall survival with the increase in risk scores, and this association was statistically significant (P < 0.001). Multivariate Cox analysis showed that the Eurolung scoring system, classified into four categories, was a significant prognostic factor of overall survival even after adjusting for covariates such as tumor histology and pathological stage (P < 0.001).
Conclusion
Stratification based on the parsimonious Eurolung scoring system showed good discriminatory ability for predicting postoperative morbidity, mortality, and long-term survival in South Korean patients with surgically resected non-small cell lung cancer. This might help clinicians to provide a detailed prognosis and decide the appropriate treatment option for high-risk patients with non-small cell lung cancer.

Keyword

Eurolung Risk Score; Lung Cancer; Surgery; Postoperative Complication

Figure

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  Fig. 1 The incidence rate of cardiopulmonary morbidities (A) and mortality (B) according to the parsimonious Eurolung risk scoring systems.

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  Fig. 2 The receiver operative characteristic curves for the (A) Eurolung 1 and (B) Eurolung 2 scoring systems.

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  Fig. 3 Overall survival curves according to the parsimonious Eurolung 2 risk score. (A) By 6 categories. (B) By 4 categories.

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  Fig. 4 Survival curves for the overall survival according to the parsimonious Eurolung risk scoring systems grouped into four categories in (A) pathological stage I, (B) stage II, and (C) stage III disease.

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