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New Prognostic Score (Essen Score) to Predict Postoperative Morbidity after Resection of Lung Metastases
Konstantinos Grapatsas1, Fabian Dörr1, Hruy Menghesha1
1Department of Thoracic Surgery, West German Cancer Center, Medical Faculty, University Hospital Essen, Ruhrlandklinik, Tueschner Weg 40, 45239 Essen, Germany.
Background:
Pulmonary metastasectomy (PM) is a widely accepted surgical procedure. This study aims to investigate postoperative morbidity and mortality after PM and develop a score to predict high-risk patients.
Methods:
We retrospectively investigated all patients undergoing a PM in our institution from November 2012 to January 2023. Complications were defined as the diagnosis of any new disease after the PM up to 30 days after the operation.
Results:
1284 patients were identified. At least one complication occurred in 145 patients (11.29%). Only one patient died during the hospital stay. Preoperative cardiovascular comorbidities (OR: 2.99, 95% CI: 1.412-3.744, p = 0.01), major lung resections (OR: 2.727, 95% CI: 1.678-4.431, p < 0.01), repeated pulmonary metastasectomy (OR: 1.759, 95% CI: 1.040-2.976, p = 0.03) and open thoracotomy (OR: 0.621, 95% CI: 0.415-0.930, p = 0.02) were identified as independent factors for postoperative complications. Based on the above independent factors for postoperative morbidity, the Essen score was developed (overall correct classification: 94.6%, ROC-Analysis: 0.828, 95% CI: 0.795-0.903).
Conclusion:
PM is a safe surgical procedure with acceptable morbidity and low mortality. The aim of the Essen score is to identify patients that are associated with risk for postoperative complications after PM.
Insights
Pulmonary metastasectomy (PM) is a safe procedure with low complications. The new Essen score helps identify patients at higher risk for postoperative complications after PM, improving patient selection.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Pulmonary metastasectomy (PM) is a standard procedure for treating metastatic lung disease.
- Assessing postoperative morbidity and mortality is crucial for patient outcomes.
- Developing predictive tools can optimize patient selection for PM.
Purpose of the Study:
- To investigate postoperative morbidity and mortality following pulmonary metastasectomy.
- To develop and validate a predictive score for identifying high-risk patients undergoing PM.
Main Methods:
- Retrospective analysis of 1284 patients who underwent PM between November 2012 and January 2023.
- Complications were defined as new diagnoses within 30 days post-operation.
- Statistical analysis identified independent predictors of postoperative complications.
Main Results:
- Overall complication rate was 11.29% with a single in-hospital mortality.
- Independent predictors for complications included cardiovascular comorbidities, major lung resections, and repeat PM.
- The developed Essen score demonstrated high predictive accuracy (94.6% correct classification, ROC 0.828).
Conclusions:
- Pulmonary metastasectomy is a safe procedure with low morbidity and mortality.
- The Essen score effectively identifies patients at risk for postoperative complications after PM.
- This score can aid in optimizing surgical decision-making and patient management.
