Assessment of textbook outcome after lobectomy for early‐stage non‐small cell lung cancer in a Korean institution: A retrospective study

Thoracic Cancer

Jaeyong Shin¹  Joonho Jung²  Jung A Son²  Woo Sik Yu²  Seokjin Haam² 

[1] Department of Preventive Medicine Yonsei University College of Medicine Seoul Korea;Department of Thoracic and Cardiovascular Surgery Ajou University School of Medicine Suwon Korea;

关键词: carcinoma;    healthcare;    non‐small cell lung cancer;    quality indicators;    thoracic surgery;   

DOI  :  10.1111/1759-7714.14391

来源: DOAJ

【 摘 要 】

Abstract Background Textbook outcome (TO) has been introduced as a novel composite measure for lung cancer surgery. We investigated TO after lobectomy for early‐stage non‐small cell lung cancer (NSCLC) in a Korean tertiary hospital and its prognostic implications for overall survival and recurrence. Methods Between January 2012 and December 2017, 418 consecutive patients who underwent lobectomy for clinical stages I and II NSCLC were identified and retrospectively reviewed. TO was defined as complete resection (negative resection margins and sufficient lymph node dissection), no 30‐day or in‐hospital mortality, no reintervention within 30 days, no readmission to the intensive care unit, no prolonged hospital stay (<14 days), no hospital readmission within 30 days, and no major complications. Propensity score matching analysis was performed to investigate the association between TO, medical costs, and long‐term outcomes. Results Of 418 patients, 277 (66.3%) achieved TO. The most common events leading to TO failure were prolonged air leakage (n = 54, 12.9%) and prolonged hospital stay (n = 53, 12.7%). Male sex (odds ratio [OR] = 2.148, p = 0.036) and low diffusing capacity for carbon monoxide (OR = 0.986, p = 0.047) were significant risk factors for failed TO in multivariate analysis. In matched cohorts, achieving TO was associated with lower medical costs and better overall survival but not cancer recurrence. Conclusions TO is associated with low medical cost and favorable overall survival; thus, surgical teams and hospitals should make efforts to improve the quality of care and achieve TO.

【 授权许可】

Unknown