摘要
Abstract
Objective To establish a risk assessment model to facilitate the surgical selection of early stage nonsmall-cell lung cancer(NSCLC),based on the classification of patients who underwent lobectomy or sublobar resection.Methods The 2012-2016 database was used for NSCLC patients who underwent a lobectomy or sublobar resection (either segmentectomy or wedge resection).A multivariable logistic regression model was utilized to determine factors associated with 30-day mortality.An associated scoring system was developed to predict the perioperative mortality within 30 d.Results Of the 3 356 patients who met study criteria,1 773 (52.8％) cases underwent lobectomy,1 281 (38.2％) cases underwent wedge resection,and 302 (9.0％) cases underwent segmentectomy.Related risk factors include age,chronic obstructive pulmonary disease,previous cerebrovascular accident or transient ischemic attack,functional status,smoking history in the past 6 months,and surgical approaches (minimally invasive or open surgery).For patients with risk scores higher than 5,the perioperative mortality rate in the lobectomy group (3.1％) was higher than that of the segmentectomy group (1.6％) or pulmonary wedge resection group (0.5 ％,P ＜ 0.01).Conclusions Among patients with a risk score of 5 or less,lobectomy confers no additional perioperative risk over sublobar resection.However,for patients with higher risk scores,their perioperative mortality of pulmonary lobectomy was significantly higher than that of sublobar resection.The risk assessment model established in this study can predict the perioperative mortality caused by different surgical approaches,which guide surgeons to select the most appropriate surgical method.关键词
癌,非小细胞肺/外科学/肺切除术/方法/Logistic模型/危险性评估Key words
carcinoma, non-small-cell lung/surgery/pneumonectomy/methods/Logistic models/risk assessment分类
医药卫生
