The surgical Apgar score predicts postoperative complications and the survival in lung cancer patients.
Lung cancer surgery
Postoperative outcomes
Prognostic marker
Surgical Apgar score
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
10
10
2022
accepted:
28
12
2022
medline:
29
8
2023
pubmed:
25
3
2023
entrez:
24
3
2023
Statut:
ppublish
Résumé
The surgical Apgar score (SAS)-calculated using the intraoperative variables estimated blood loss, lowest heart rate, and lowest mean systolic pressure-is associated with mortality in cancer surgery. We investigated the utility of the SAS in patients with lung cancer undergoing surgery. We retrospectively analyzed the data of 691 patients who underwent surgery for primary lung cancer between 2015 and 2019 in a single institute and analyzed the impact of the SAS. Of the 691 patients, 138 (20%), 57 (8.2%), and 7 (1.0%) had postoperative complications of all grades, grades ≥ III, and grade V, respectively, according to the Clavien-Dindo classification. The C-index for postoperative complications of grades ≥ III was 0.605. A lower score (0-5 points) (odds ratio 3.09 against 8-10 points, P = 0.04) and a lower percentage of vital capacity (odds ratio 0.97, P = 0.04) were independent negative risk factors for major postoperative complications. Patients with a lower score (0-5 points) had poor 5-year overall and cancer-specific survival rates (60.1% and 72.3%, respectively; P < 0.05 for both). The surgical Apgar score predicted postoperative complications and the long-term survival. Surgeons may improve surgical results using the SAS.
Identifiants
pubmed: 36961607
doi: 10.1007/s00595-023-02677-x
pii: 10.1007/s00595-023-02677-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1019-1027Informations de copyright
© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.
Références
Nakamura K, Ukawa S, Okada E, Hirata M, Nagai A, Yamagata Z, et al. Characteristics and prognosis of Japanese male and female lung cancer patients: the biobank Japan project. J Epidemiol. 2017;27:S49-57.
doi: 10.1016/j.je.2016.12.010
pubmed: 28202209
pmcid: 5350589
Herbst RS, Morgensztern D, Boshoff C. The biology and management of non-small cell lung cancer. Nature. 2018;553:446–54.
doi: 10.1038/nature25183
pubmed: 29364287
Yao L, Luo J, Liu L, Wu Q, Zhou R, Li L, et al. Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery: a retrospective study. Medicine (Baltimore). 2021;100: e25295.
doi: 10.1097/MD.0000000000025295
pubmed: 33787617
Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ. An Apgar score for surgery. J Am Coll Surg. 2007;204:201–8.
doi: 10.1016/j.jamcollsurg.2006.11.011
pubmed: 17254923
Regenbogen SE, Ehrenfeld JM, Lipsitz SR, Greenberg CC, Hutter MM, Gawande AA. Utility of the surgical apgar score: validation in 4119 patients. Arch Surg. 2009;144:30–6.
doi: 10.1001/archsurg.2008.504
pubmed: 19153322
Nakagawa A, Nakamura T, Oshikiri T, Hasegawa H, Yamamoto M, Kanaji S, et al. The surgical Apgar score predicts not only short-term complications but also long-term prognosis after esophagectomy. Ann Surg Oncol. 2017;24:3934–46.
doi: 10.1245/s10434-017-6103-0
pubmed: 28986819
Miki Y, Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Terashima M. Perioperative risk assessment for gastrectomy by surgical apgar score. Ann Surg Oncol. 2014;21:2601–7.
doi: 10.1245/s10434-014-3653-2
pubmed: 24664626
Vogelsang RP, Bojesen RD, Hoelmich ER, Orhan A, Buzquurz F, Cai L, et al. Prediction of 90-day mortality after surgery for colorectal cancer using standardized nationwide quality-assurance data. BJS Open. 2021;5:zrab023.
doi: 10.1093/bjsopen/zrab023
pubmed: 33963368
pmcid: 8105588
Yamamoto M, Kurata K, Asai-Sato M, Shiomi M, Ueda Y, Aoki Y, et al. Low surgical Apgar score in older patients with gynecological cancer is a risk factor for postoperative complications and 1-year mortality: a multicenter retrospective cohort study. Mol Clin Oncol. 2021;14:21.
doi: 10.3892/mco.2020.2183
pubmed: 33363731
Prince AC, Day KE, Lin CP, Greene BJ, Carroll WR. Utility of the surgical Apgar score in head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg. 2018;159:466–72.
doi: 10.1177/0194599818767626
pubmed: 29870298
pmcid: 6659718
Urrutia J, Valdes M, Zamora T, Canessa V, Briceno J. Can the surgical Apgar score predict morbidity and mortality in general orthopaedic surgery? Int Orthop. 2012;36:2571–6.
doi: 10.1007/s00264-012-1696-1
pubmed: 23129225
pmcid: 3508032
Ziewacz JE, Davis MC, Lau D, El-Sayed AM, Regenbogen SE, Sullivan SE, et al. Validation of the surgical Apgar score in a neurosurgical patient population. J Neurosurg. 2013;118:270–9.
doi: 10.3171/2012.10.JNS12436
pubmed: 23121434
Nagoya A, Kanzaki R, Kimura K, Fukui E, Kanou T, Ose N, et al. Utility of the surgical Apgar score for predicting the short- and long-term outcomes in non-small-cell lung cancer patients who undergo surgery. Interact Cardiovasc Thorac Surg. 2022;35:ivac50.
doi: 10.1093/icvts/ivac150
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.
doi: 10.1016/0021-9681(87)90171-8
pubmed: 3558716
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.
doi: 10.1097/01.sla.0000133083.54934.ae
pubmed: 15273542
pmcid: 1360123
Rami-Porta R, Bolejack V, Giroux DJ, Chansky K, Crowley J, Asamura H, et al. The IASLC lung cancer staging project the new database to inform the eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2014;9:1618–24.
doi: 10.1097/JTO.0000000000000334
pubmed: 25436796
Travis WD, Brambilla E, Müller-Hermelink HK, Harris CC. Pathology and genetics of tumours of the lung, pleura, thymus and heart. In: Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC, editors. World health organization classification of tumours. Lyon: IARC Press; 2004. p. 9–124.
Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32:260–7.
doi: 10.1213/00000539-195301000-00041
pubmed: 13083014
Lin YC, Chen YC, Yang CH, Su NY. Surgical Apgar score is strongly associated with postoperative ICU admission. Sci Rep. 2021;11:115.
doi: 10.1038/s41598-020-80393-z
pubmed: 33420227
pmcid: 7794529
Villeneuve PJ. Interventions to avoid pulmonary complications after lung cancer resection. J Thorac Dis. 2018;10:S3781–8.
doi: 10.21037/jtd.2018.09.26
pubmed: 30505565
pmcid: 6258661
Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE. APACHE - acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med. 1981;9:591–7.
doi: 10.1097/00003246-198108000-00008
pubmed: 7261642
Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit. Br J Surg. 1991;78:356–60.
Haga Y, Ikei S, Ogawa M. Estimation of physiologic ability and surgical stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery. Surg Today. 1999;29:219–25.
doi: 10.1007/BF02483010
pubmed: 10192731
Giangiuliani G, Gui D, Bonatti P, Tozzi P, Caracciolo F. APACHE II in surgical lung carcinoma patients. Chest. 1990;98:627–30.
doi: 10.1378/chest.98.3.627
pubmed: 2168310
Brunelli A, Fianchini A, Gesuita R, Carle F. POSSUM scoring system as an instrument of audit in lung resection surgery. Physiological and operative severity score for the enumeration of mortality and morbidity. Ann Thorac Surg. 1999;67:329–31.
doi: 10.1016/S0003-4975(98)00822-4
pubmed: 10197649
Yamashita S, Haga Y, Nemoto E, Nagai S, Ohta M. E-PASS (The estimation of physiologic ability and surgical stress) scoring system helps the prediction of postoperative morbidity and mortality in thoracic surgery. Eur Surg Res. 2004;36:249–55.
doi: 10.1159/000078860
pubmed: 15263831
Horvath B, Kloesel B, Todd MM, Cole DJ, Prielipp RC. The evolution, current value, and future of the American society of anesthesiologists physical status classification system. Anesthesiology. 2021;135:904–19.
doi: 10.1097/ALN.0000000000003947
pubmed: 34491303
Fernandez FG, Kosinski AS, Burfeind W, Park B, DeCamp MM, Seder C, et al. The society of thoracic surgeons lung cancer resection risk model: higher quality data and superior outcomes. Ann Thorac Surg. 2016;102:370–7.
doi: 10.1016/j.athoracsur.2016.02.098
pubmed: 27209606
pmcid: 5016798
Chudgar N, Yan S, Hsu M, Tan KS, Gray KD, Molena D, et al. The American college of surgeons surgical risk calculator performs well for pulmonary resection: a validation study. J Thorac Cardiovasc Surg. 2022;163:1509–16.
doi: 10.1016/j.jtcvs.2021.01.036
pubmed: 33610360
Brunelli A, Salati M, Rocco G, Varela G, Van Raemdonck D, Decaluwe H, et al. European risk models for morbidity (EuroLung1) and mortality (EuroLung2) to predict outcome following anatomic lung resections: an analysis from the European society of thoracic surgeons database. Eur J Cardiothorac Surg. 2017;51:490–7.
pubmed: 27744321
Endo S, Ikeda N, Kondo T, Nakajima J, Kondo H, Yokoi K, et al. Model of lung cancer surgery risk derived from a Japanese nationwide web-based database of 78 594 patients during 2014–2015. Eur J Cardiothorac Surg. 2017;52:1182–9.
doi: 10.1093/ejcts/ezx190
pubmed: 28977408
pmcid: 5848741