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Eurolung risk score is associated with long-term survival after curative resection for lung cancer
Authors:Alessandro Brunelli  Nilanjan Chaudhuri  Manos Kefaloyannis  Richard Milton  Cecilia Pompili  Peter Tcherveniakov  Kostas Papagiannopoulos
Institution:Department of Thoracic Surgery, St James''s University Hospital Bexley Wing, Leeds, United Kingdom
Abstract:ObjectiveThe study objective was to verify whether the Eurolung score was associated with long-term prognosis after lung cancer resection.MethodsA total of 1359 consecutive patients undergoing anatomic lung resection (1136 lobectomies, 103 pneumonectomies, 120 segmentectomies) (2014-2018) were analyzed. The parsimonious aggregate Eurolung2 score was calculated for each patient. Median follow-up was 802 days. Survival distribution was estimated by the Kaplan–Meier method. Cox proportional hazard regression and competing risk regression analyses were used to assess the independent association of Eurolung with overall and disease-specific survival.ResultsPatients were grouped into 4 classes according to their Eurolung scores (A 0-2.5, B 3-5, C 5.5-6.5, D 7-11.5). Most patients were in class A (52%) and B (33%), 8% were in class C, and 7% were in class D. Five-year overall survival decreased across the categories (A: 75%; B: 52%; C: 29%; D: 27%, log rank P < .0001). The score stratified the 3-year overall survival in patients with pT1 (P < .0001) or pT>1 (P < .0001). In addition, the different classes were associated with incremental risk of long-term overall mortality in patients with pN0 (P < .0001) and positive nodes (P = .0005). Cox proportional hazard regression and competing regression analyses showed that Eurolung aggregate score remained significantly associated with overall (hazard ratio, 1.19; P < .0001) and disease-specific survival after adjusting for pT and pN stage (hazard ratio, 1.09; P = .005).ConclusionsEurolung aggregate score was associated with long-term survival after curative resection for cancer. This information may be valuable to inform the shared decision-making process and the multidisciplinary team discussion assisting in the selection of the most appropriate curative treatment in high-risk patients.
Keywords:lung cancer  surgery  risk model  Eurolung  survival  risk stratification  BMI"}  {"#name":"keyword"  "$":{"id":"kwrd0020"}  "$$":[{"#name":"text"  "_":"body mass index  CI"}  {"#name":"keyword"  "$":{"id":"kwrd0030"}  "$$":[{"#name":"text"  "_":"confidence interval  DSS"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"disease-specific survival  ESTS"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"European Society of Thoracic Surgeons  OS"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"overall survival  ppoFEV1"}  {"#name":"keyword"  "$":{"id":"kwrd0070"}  "$$":[{"#name":"text"  "_":"predicted postoperative forced expiratory volume in 1 second
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