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Ozeas Galeno Da Rocha Neto



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    P2.17 - Treatment of Early Stage/Localized Disease (ID 189)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment of Early Stage/Localized Disease
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.17-13 - Thoracoscore Fails to Predict In-Hospital Mortality Following Elective Surgery in a Brazilian Lung Cancer Cohort (Now Available) (ID 1973)

      10:15 - 18:15  |  Author(s): Ozeas Galeno Da Rocha Neto

      • Abstract
      • Slides

      Background

      According to SEER database only 40% of patients with lung cancer present localized or regional disease at diagnosis. The cornerstone of treatment of potentially resectable lung cancer is surgical removal of the tumor and it is important to estimate the loss of lung function after resection. The risk of in-hospital death can be estimated by some a scores system such as Thoracoscore. The aim of this study is to evaluate the applicability of this risk assessment model for in-hospital mortality in a Brazilian cohort of patients submitted to surgical resection.

      Method

      This is a prospective analysis of patients who underwent lung resection for lung cancer in two thoracic surgery centers in Brazil between January 2015 to December 2018. Patients were included if they were 18yo or older, had a histologically proven diagnosis of lung cancer. Tumor staging was done according the seventh edition of the AJCC classification. Data on prognostic factors such as histology, gender, performance status, comorbidities and type of treatment were collected. Thoracoscore was calculated based on the following variables: age, sex, American Society of Anaesthesiologists' class (ASA), performance status classification, dyspnea score, priority of surgery, procedure class, diagnosis group and comorbidities score. A receiver operating characteristic analysis determined the ability of the thoracoscore to predict in-hospital mortality and it would be considered acceptable if AUC > 0.7; significance test for AUC was performed using Chi-square test. Proportion of events was compared between groups according to the Cochran-Armitage linear trend test to evaluate the calibration of Thoracoscore. All P-values were 2-sided. Results were considered significant if p < 0.05. Statistical analyses were performed using SAS version 9.4.

      Result

      166 patients were included in the study. Median age was 62 years, 48,8% were male, 57.8% had adenocarcinoma, 71.7% had one or two comorbidities, 40.3%, 36.1%, 19.2% and 3.6% were respectively clinical stage I, II, III and IV, 71% and 13.3% underwent respectively lobectomy/bilobectomy and pneumectomy, 79.5% were ASA ≤2, 100% had ECOG ≤2, elective surgery and dyspnea score ≤2. The observed in-hospital mortality was 13 patients (7.8%). We attributed our mortality to high rate of stage III lung cancer patients and we also included stage IV patients who underwent to palliative surgery. Mean thoracoscore was 3.92 (SD ± 1.41) and the mean predicted in-hospital mortality using thoracoscore was 1.81%. The AUC for thoracoscore was 0.579. When this area was compared with the area of 0.50 (absent discrimination), no significant difference was observed (p = 0.3642). Thoracoscore was divided into three risk groups: low (0–3), moderate (3.1–5) and high (≥5.1). The score was not able to differentiate the mortality among the groups (p = 0.30).

      Conclusion

      Our results corroborate the non-validation of Thoracoescore in a Brazilian population of patients with lung cancer. Additional studies are needed for the development of more accurate mortality risk scores in this population.

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