Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78 594 patients during 2014-2015

Shunsuke Endo, Norihiko Ikeda, Takashi Kondo, Jun Nakajima, Haruhiko Kondo, Kohei Yokoi, Masayuki Chida, Masami Sato, Shinichi Toyooka, Koichi Yoshida, Yoshinori Okada, Yukio Sato, Morihito Okada, Meinoshin Okumura, Koji Chihara, Eriko Fukuchi, Hiroaki Miyata

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVES: Using data obtained from a Japanese nationwide annual database with web-based data entry, we developed a risk model of mortality and morbidity after lung cancer surgery. METHODS: The characteristics and operative and postoperative data from 80 095 patients who underwent lung cancer surgery were entered into the annual National Clinical Database of Japan data sets for 2014 and 2015. After excluding 1501 patients, the development data set for risk models included 38 277 patients entering in 2014 and the validation data set included 40 317 patients entering in 2015. Receiver-operating characteristic curves were generated for the outcomes of mortality and composite mortality/major morbidity. The concordance index was used to assess the discriminatory ability and validity of the model. RESULTS: The 30-day mortality and overall mortality rates, including in-hospital deaths, were 0.4% and 0.8%, respectively, in 2014, and 0.4% and 0.8%, respectively, in 2015. The rate of major morbidity was 5.6% in 2014 and 5.6% in 2015. Several risk factors were significantly associated with mortality, namely, male sex, performance status, comorbidities of interstitial pneumonia and liver cirrhosis, haemodialysis and the surgical procedure pneumonectomy. The concordance index for mortality and composite mortality/major morbidity was 0.854 (P < 0.001) and 0.718 (P < 0.001), respectively, for the development data set and 0.849 (P < 0.001) and 0.723 (P < 0.001), respectively, for the validation data set. CONCLUSIONS: This model was satisfactory for predicting surgical outcomes after pulmonary resection for lung cancer in Japan and will aid preoperative assessment and improve clinical outcomes for lung cancer surgery.

Original languageEnglish
Pages (from-to)1182-1189
Number of pages8
JournalEuropean Journal of Cardio-thoracic Surgery
Volume52
Issue number6
DOIs
Publication statusPublished - Dec 1 2017

Fingerprint

Lung Neoplasms
Databases
Mortality
Morbidity
Japan
Pneumonectomy
Interstitial Lung Diseases
ROC Curve
Liver Cirrhosis
Renal Dialysis
Comorbidity
Datasets
Lung

Keywords

  • Lung cancer
  • Nationwide survey
  • Risk model
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78 594 patients during 2014-2015. / Endo, Shunsuke; Ikeda, Norihiko; Kondo, Takashi; Nakajima, Jun; Kondo, Haruhiko; Yokoi, Kohei; Chida, Masayuki; Sato, Masami; Toyooka, Shinichi; Yoshida, Koichi; Okada, Yoshinori; Sato, Yukio; Okada, Morihito; Okumura, Meinoshin; Chihara, Koji; Fukuchi, Eriko; Miyata, Hiroaki.

In: European Journal of Cardio-thoracic Surgery, Vol. 52, No. 6, 01.12.2017, p. 1182-1189.

Research output: Contribution to journalArticle

Endo, S, Ikeda, N, Kondo, T, Nakajima, J, Kondo, H, Yokoi, K, Chida, M, Sato, M, Toyooka, S, Yoshida, K, Okada, Y, Sato, Y, Okada, M, Okumura, M, Chihara, K, Fukuchi, E & Miyata, H 2017, 'Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78 594 patients during 2014-2015', European Journal of Cardio-thoracic Surgery, vol. 52, no. 6, pp. 1182-1189. https://doi.org/10.1093/EJCTS/EZX190
Endo, Shunsuke ; Ikeda, Norihiko ; Kondo, Takashi ; Nakajima, Jun ; Kondo, Haruhiko ; Yokoi, Kohei ; Chida, Masayuki ; Sato, Masami ; Toyooka, Shinichi ; Yoshida, Koichi ; Okada, Yoshinori ; Sato, Yukio ; Okada, Morihito ; Okumura, Meinoshin ; Chihara, Koji ; Fukuchi, Eriko ; Miyata, Hiroaki. / Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78 594 patients during 2014-2015. In: European Journal of Cardio-thoracic Surgery. 2017 ; Vol. 52, No. 6. pp. 1182-1189.
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abstract = "OBJECTIVES: Using data obtained from a Japanese nationwide annual database with web-based data entry, we developed a risk model of mortality and morbidity after lung cancer surgery. METHODS: The characteristics and operative and postoperative data from 80 095 patients who underwent lung cancer surgery were entered into the annual National Clinical Database of Japan data sets for 2014 and 2015. After excluding 1501 patients, the development data set for risk models included 38 277 patients entering in 2014 and the validation data set included 40 317 patients entering in 2015. Receiver-operating characteristic curves were generated for the outcomes of mortality and composite mortality/major morbidity. The concordance index was used to assess the discriminatory ability and validity of the model. RESULTS: The 30-day mortality and overall mortality rates, including in-hospital deaths, were 0.4{\%} and 0.8{\%}, respectively, in 2014, and 0.4{\%} and 0.8{\%}, respectively, in 2015. The rate of major morbidity was 5.6{\%} in 2014 and 5.6{\%} in 2015. Several risk factors were significantly associated with mortality, namely, male sex, performance status, comorbidities of interstitial pneumonia and liver cirrhosis, haemodialysis and the surgical procedure pneumonectomy. The concordance index for mortality and composite mortality/major morbidity was 0.854 (P < 0.001) and 0.718 (P < 0.001), respectively, for the development data set and 0.849 (P < 0.001) and 0.723 (P < 0.001), respectively, for the validation data set. CONCLUSIONS: This model was satisfactory for predicting surgical outcomes after pulmonary resection for lung cancer in Japan and will aid preoperative assessment and improve clinical outcomes for lung cancer surgery.",
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T1 - Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78 594 patients during 2014-2015

AU - Endo, Shunsuke

AU - Ikeda, Norihiko

AU - Kondo, Takashi

AU - Nakajima, Jun

AU - Kondo, Haruhiko

AU - Yokoi, Kohei

AU - Chida, Masayuki

AU - Sato, Masami

AU - Toyooka, Shinichi

AU - Yoshida, Koichi

AU - Okada, Yoshinori

AU - Sato, Yukio

AU - Okada, Morihito

AU - Okumura, Meinoshin

AU - Chihara, Koji

AU - Fukuchi, Eriko

AU - Miyata, Hiroaki

PY - 2017/12/1

Y1 - 2017/12/1

N2 - OBJECTIVES: Using data obtained from a Japanese nationwide annual database with web-based data entry, we developed a risk model of mortality and morbidity after lung cancer surgery. METHODS: The characteristics and operative and postoperative data from 80 095 patients who underwent lung cancer surgery were entered into the annual National Clinical Database of Japan data sets for 2014 and 2015. After excluding 1501 patients, the development data set for risk models included 38 277 patients entering in 2014 and the validation data set included 40 317 patients entering in 2015. Receiver-operating characteristic curves were generated for the outcomes of mortality and composite mortality/major morbidity. The concordance index was used to assess the discriminatory ability and validity of the model. RESULTS: The 30-day mortality and overall mortality rates, including in-hospital deaths, were 0.4% and 0.8%, respectively, in 2014, and 0.4% and 0.8%, respectively, in 2015. The rate of major morbidity was 5.6% in 2014 and 5.6% in 2015. Several risk factors were significantly associated with mortality, namely, male sex, performance status, comorbidities of interstitial pneumonia and liver cirrhosis, haemodialysis and the surgical procedure pneumonectomy. The concordance index for mortality and composite mortality/major morbidity was 0.854 (P < 0.001) and 0.718 (P < 0.001), respectively, for the development data set and 0.849 (P < 0.001) and 0.723 (P < 0.001), respectively, for the validation data set. CONCLUSIONS: This model was satisfactory for predicting surgical outcomes after pulmonary resection for lung cancer in Japan and will aid preoperative assessment and improve clinical outcomes for lung cancer surgery.

AB - OBJECTIVES: Using data obtained from a Japanese nationwide annual database with web-based data entry, we developed a risk model of mortality and morbidity after lung cancer surgery. METHODS: The characteristics and operative and postoperative data from 80 095 patients who underwent lung cancer surgery were entered into the annual National Clinical Database of Japan data sets for 2014 and 2015. After excluding 1501 patients, the development data set for risk models included 38 277 patients entering in 2014 and the validation data set included 40 317 patients entering in 2015. Receiver-operating characteristic curves were generated for the outcomes of mortality and composite mortality/major morbidity. The concordance index was used to assess the discriminatory ability and validity of the model. RESULTS: The 30-day mortality and overall mortality rates, including in-hospital deaths, were 0.4% and 0.8%, respectively, in 2014, and 0.4% and 0.8%, respectively, in 2015. The rate of major morbidity was 5.6% in 2014 and 5.6% in 2015. Several risk factors were significantly associated with mortality, namely, male sex, performance status, comorbidities of interstitial pneumonia and liver cirrhosis, haemodialysis and the surgical procedure pneumonectomy. The concordance index for mortality and composite mortality/major morbidity was 0.854 (P < 0.001) and 0.718 (P < 0.001), respectively, for the development data set and 0.849 (P < 0.001) and 0.723 (P < 0.001), respectively, for the validation data set. CONCLUSIONS: This model was satisfactory for predicting surgical outcomes after pulmonary resection for lung cancer in Japan and will aid preoperative assessment and improve clinical outcomes for lung cancer surgery.

KW - Lung cancer

KW - Nationwide survey

KW - Risk model

KW - Surgery

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