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A Multiple-Center Nomogram to Predict Pneumonectomy Complication Risk for Non-Small Cell Lung Cancer Patients

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

This study aimed to construct a nomogram to quantitatively predict pneumonectomy complication risks for non-small cell lung cancer (NSCLC) patients.

Methods

Data from 1052 NSCLC patients who underwent pneumonectomy were retrospectively retrieved from the databases of three thoracic centers. Multivariable logistic regression was used to investigate postoperative morbidity predictors. Clinical parameters and operative features were analyzed using univariable and multivariable logistic regression analyses, and a nomogram to predict the risk of postoperative complications was constructed using bootstrap resampling. A receiver operating characteristic (ROC) curve was used to estimate the discrimination power for the nomogram.

Results

A total of 212 patients (20.2%) had major complications. After regression analysis, forced expiratory volume in 1 s, Charlson Comorbidity Index score, male sex, and right-sided pneumonectomy were identified and entered into the nomogram. The nomogram showed a robust discrimination, with an area under the ROC curve of 0.753 (95% confidence interval 0.604–0.818). The calibration curves for the probability of postoperative complications showed optimal agreement between the nomogram and the actual probability.

Conclusions

Based on preoperative data, we developed a nomogram for predicting complication risks after pneumonectomy. This model may be helpful for thoracic surgeons in selecting appropriate patients for adopting prophylactic measures after surgery.

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Acknowledgments

This study was supported by the Beijing Municipal Administration of Hospitals Incubating Program (Code: PX2021060) and the National Nature Science Foundation of China (No. 81670089). The authors thank LetPub (www.letpub.com) for their linguistic assistance during the preparation of this manuscript.

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Author notes

  1. Chong Wang and Shaodong Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China

    Zhixin Li MD & Wenxin He MD

  2. Minimally Invasive Treatment Center, Beijing Chest Hospital, Beijing, China

    Chong Wang MD

  3. Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China

    Shaodong Wang MD

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  1. Chong Wang MD
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  2. Shaodong Wang MD
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  3. Zhixin Li MD
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Correspondence to Zhixin Li MD or Wenxin He MD.

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Wang Chong, Wang Shaodong, He Wenxin, and Li Zhixin declare no conflicts of interest.

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Appendix 1

Appendix 1

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Table 3 Clavien–Dindo classification of surgical complications
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Wang, C., Wang, S., Li, Z. et al. A Multiple-Center Nomogram to Predict Pneumonectomy Complication Risk for Non-Small Cell Lung Cancer Patients. Ann Surg Oncol 29, 561–569 (2022). https://doi.org/10.1245/s10434-021-10504-1

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